A prospective cohort study of the association between drinking water arsenic exposure and self-reported maternal health symptoms during pregnancy in Bangladesh

Details

• Alternative Title:
  Environ Health
• Personal Author:
  Kile, Molly L ; Rodrigues, Ema G ; Mazumdar, Maitreyi ; Dobson, Christine B ; Diao, Nancy ; Golam, Mostofa ; Quamruzzaman, Quazi ; Rahman, Mahmudar ; Christiani, David C
• Description:
  Background
  
  Arsenic, a common groundwater pollutant, is associated with adverse reproductive health but few studies have examined its effect on maternal health.
  
  Methods
  
  A prospective cohort was recruited in Bangladesh from 2008–2011 (N = 1,458). At enrollment (<16 weeks gestational age [WGA]), arsenic was measured in personal drinking water using inductively-coupled plasma mass spectrometry. Questionnaires collected health data at enrollment, at 28 WGA, and within one month of delivery. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CI) for self-reported health symptoms were estimated for each arsenic quartile using logistic regression.
  
  Results
  
  Overall, the mean concentration of arsenic was 38 μg/L (Standard deviation, 92.7 μg/L). A total of 795 women reported one or more of the following symptoms during pregnancy (cold/flu/infection, nausea/vomiting, abdominal cramping, headache, vaginal bleeding, or swollen ankles). Compared to participants exposed to the lowest quartile of arsenic (≤0.9 μg/L), the aOR for reporting any symptom during pregnancy was 0.62 (95% CI = 0.44-0.88) in the second quartile, 1.83 (95% CI = 1.25-2.69) in the third quartile, and 2.11 (95% CI = 1.42-3.13) in the fourth quartile where the mean arsenic concentration in each quartile was 1.5 μg/L, 12.0 μg/L and 144.7 μg/L, respectively. Upon examining individual symptoms, only nausea/vomiting and abdominal cramping showed consistent associations with arsenic exposure. The odds of self-reported nausea/vomiting was 0.98 (95% CI: 0.68, 1.41), 1.52 (95% CI: 1.05, 2.18), and 1.81 (95% CI: 1.26, 2.60) in the second, third and fourth quartile of arsenic relative to the lowest quartile after adjusting for age, body mass index, second-hand tobacco smoke exposure, educational status, parity, anemia, ferritin, medication usage, type of sanitation at home, and household income. A positive trend was also observed for abdominal cramping (P for trend <0.0001). A marginal negative association was observed between arsenic quartiles and odds of self-reported cold/flu/infection (P for trend = 0.08). No association was observed between arsenic and self-reported headache (P for trend = 0.19).
  
  Conclusion
  
  Moderate exposure to arsenic contaminated drinking water early in pregnancy was associated with increased odds of experiencing nausea/vomiting and abdominal cramping. Preventing exposure to arsenic contaminated drinking water during pregnancy could improve maternal health.
  
  
• Subjects:
  Abdominal Pain Adult Arsenic Drinking Water Environmental Exposure Female Humans Maternal Welfare Odds Ratio Pregnancy Prospective Studies Research Self Report Water Pollutants, Chemical Young Adult

  More +
• Source:
  Environ Health. 2014; 13:29.
• Pubmed ID:
  24735908
• Pubmed Central ID:
  PMC4021291
• Document Type:
  Journal Article
• Funding:
  K01 ES017800/ES/NIEHS NIH HHS/United States ; K23 ES017437/ES/NIEHS NIH HHS/United States ; P30 ES000002/ES/NIEHS NIH HHS/United States ; P30 ES000210/ES/NIEHS NIH HHS/United States ; P42 ES016454/ES/NIEHS NIH HHS/United States ; R01 ES015533/ES/NIEHS NIH HHS/United States ; R01ES015533/ES/NIEHS NIH HHS/United States ; T41 OH008416/OH/NIOSH CDC HHS/United States
• Place as Subject:
  Bangladesh
• Volume:
  13
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:72489a7b5d4f2d46402435ad09c550b2f07bee800f66a4be0bc119b0c51b93be
• Download URL:
  https://stacks.cdc.gov/view/cdc/23113/cdc_23113_DS1.pdf
• File Type:
  [PDF - 221.84 KB ]