Associations between prenatal arsenic exposure with adverse pregnancy outcome and child mortality.

Yu-Hsuan Shih, Tariqul Islam, Samar Kumar Hore, Golam Sarwar, Mohammad Hasan Shahriar, Mohammad Yunus, Joseph H Graziano, Judith Harjes, John A Baron, Faruque Parvez, Habibul Ahsan, Maria Argos

Environmental research 2017 Oct

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Chronic arsenic exposure is a public health concern in many parts of the world, with elevated concentrations in groundwater posing a threat to millions of people. Arsenic is associated with various cancers and an array of chronic diseases; however, the relationship with adverse pregnancy outcomes and child mortality is less established. We evaluated associations between individual-level prenatal arsenic exposure with adverse pregnancy outcomes and child mortality in a pregnancy study among 498 women nested in a larger population-based cohort in rural Bangladesh. Creatinine-adjusted urinary total arsenic concentration, a comprehensive measure of exposure from water, food, and air sources, reflective of the prenatal period was available for participants. Self-reported pregnancy outcomes (livebirth, stillbirth, spontaneous/elective abortion) were ascertained. Generalized estimating equations, accounting for multiple pregnancies of participants, were used to estimate odds ratios and 95% confidence intervals in relation to adverse pregnancy outcomes. Vital status of livebirths was subsequently ascertained through November 2015. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals in relation to child mortality. We observed a significant association between prenatal arsenic exposure and the risk of stillbirth (greater than median; adjusted OR = 2.50; 95% CI = 1.04, 6.01). We also observed elevated risk of child mortality (greater than median; adjusted HR = 1.92; 95% CI = 0.78, 4.68) in relation to prenatal arsenic exposure. Prospective studies should continue to evaluate prenatal and early life health effects of arsenic exposure and arsenic remediation strategies for women of child-bearing age. Copyright © 2017 Elsevier Inc. All rights reserved.

Citation

Yu-Hsuan Shih, Tariqul Islam, Samar Kumar Hore, Golam Sarwar, Mohammad Hasan Shahriar, Mohammad Yunus, Joseph H Graziano, Judith Harjes, John A Baron, Faruque Parvez, Habibul Ahsan, Maria Argos. Associations between prenatal arsenic exposure with adverse pregnancy outcome and child mortality. Environmental research. 2017 Oct;158:456-461