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Maternal drinking water arsenic exposure and perinatal outcomes in Inner Mongolia, China
Citation:
LOBDELL, D. T., S. MYERS, Z. Liu, Y. Xia, Z. Nig, R. Kwok, J. S. MUMFORD, AND P. MENDOLA. Maternal drinking water arsenic exposure and perinatal outcomes in Inner Mongolia, China. Presented at 21st Annual Society for Pediatric and Perinatal Epidemiology meeting , Chicago, IL, June 23 - 24, 2008.
Impact/Purpose:
research results
Description:
Exposure to high levels of arsenic has been reported to increase adverse birth outcomes including spontaneous abortion, preterm birth, and low birthweight. This study evaluated the relationship between maternal arsenic exposure and perinatal endpoints (term birthweight, preterm birth, stillbirth, neonatal death) in Inner Mongolia, China where a wide range of naturally occurring arsenic in drinking water is present. Perinatal outcomes were abstracted from prenatal care records for all singleton deliveries in a defined geographic area from December 1, 1996-December 31, 1999 (n=9,890). Exposure was based on well water measures for the maternal subvillage. Analysis of covariance was used to compare mean birthweight at term among arsenic categories: below limit of detection (BLD)-20 (referent); 21-50; 51-100; >100 µg/L. Associations with stillbirth, preterm birth, and neonatal death were examined by logistic regression, with arsenic exposure dichotomized as BLD-50 and >50 µg/L. Term birthweight was 0.05 kg higher (95% CI: 0.02, 0.08 kg) in the highest exposure category compared to the referent. Arsenic >50 µg/L was associated with an increased risk of neonatal death (Odds Ratio=2.01; 95% CI: 1.12, 3.59). No relationship was found between maternal arsenic exposure and preterm or stillbirth delivery. At the levels observed in our study, arsenic does not appear to contribute to adverse birth outcomes. Exposure may play a role in neonatal death, but the neonatal death rate in this population is low and this potential association merits further research. In contrast to previous studies, where arsenic exposure is often confounded by poor health status, women in this population are generally in good health and live in a farming area where fresh food is readily available. Health and nutritional status may be important modifiers of an arsenic effect on birth outcome