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

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Title A prospective cohort study of the association between drinking water arsenic exposure and self-reported maternal health symptoms during pregnancy in Bangladesh
Names Kile, Molly L. (creator)
Rodrigues, Ema G. (creator)
Mazumdar, Maitreyi (creator)
Dobson, Christine B. (creator)
Diao, Nancy (creator)
Golam, Mostofa (creator)
Quamruzzaman, Quazi (creator)
Rahman, Mahmudar (creator)
Christiani, David C. (creator)
Date Issued 2014-04-16 (iso8601)
Note This is the publisher’s final pdf. The published article is copyrighted by the author(s) and published by BioMed Central Ltd. The published article can be found at: http://www.ehjournal.net/.
Abstract 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.
Genre Article
Access Condition http://creativecommons.org/licenses/by/3.0/us/
Topic Arsenic
Identifier Kile et al.: A prospective cohort study of the association between drinking water arsenic exposure and self-reported maternal health symptoms during pregnancy in Bangladesh. Environmental Health 2014 13:29. doi:10.1186/1476-069X-13-29

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