| 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.
- Keywords: Nausea, Maternal health, Environmental health, Arsenic, Vomiting, Reproductive health, Cramping
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