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Maternal drinking water arsenic exposure and perinatal outcomes in Inner Mongolia, China
  1. S L Myers1,
  2. D T Lobdell2,
  3. Z Liu3,
  4. Y Xia4,
  5. H Ren3,
  6. Y Li3,
  7. R K Kwok5,
  8. J L Mumford2,
  9. P Mendola6
  1. 1Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  2. 2Office of Research and Development, National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
  3. 3Ba Men Anti-Epidemic Station, Ba Men, Inner Mongolia, China
  4. 4Inner Mongolia Center for Endemic Disease Control and Research, Huhhot, Inner Mongolia, China
  5. 5RTI International, Research Triangle Park, North Carolina, USA
  6. 6National Center for Health Statistics, Hyattsville, Maryland, USA
  1. Correspondence to Danelle T Lobdell, Office of Research and Development, National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, MD58A, Research Triangle Park, NC 27711, USA; lobdell.danelle{at}epa.gov

Abstract

Background Bayingnormen is a region located in western Inner Mongolia China, with a population that is exposed to a wide range of drinking water arsenic concentrations. The relationship between maternal drinking water arsenic exposure and perinatal endpoints (term birth weight, preterm birth, stillbirth and neonatal death) in this region was evaluated in this study.

Methods An analysis was conducted of all singleton deliveries in a defined geographical area of Inner Mongolia from December 1996 to December 1999 (n=9890). Outcome and covariate data were abstracted from prenatal care records. Exposure was based on well-water measures for the maternal subvillage. Mean birth weight at term was compared across four arsenic categories using analysis of covariance. ORs for stillbirth, preterm birth and neonatal death were estimated by logistic regression with arsenic exposure dichotomised at 50 μg/l.

Results Term birth weight was 0.05 kg higher (95% CI 0.02 to 0.08) in the highest exposure category (>100 μg/l) compared to the reference (below limit of detection to 20 μg/l). Arsenic >50 μg/l was associated with an increased risk of neonatal death (OR 2.01, 95% CI 1.12 to 3.59). No relationship was found between maternal arsenic exposure and preterm or stillbirth delivery.

Conclusions 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; however, the neonatal death rate in this population was low and this potential association merits further research.

  • Arsenic
  • water
  • China
  • pregnancy outcome
  • neonatal death

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Footnotes

  • Funding This research was conducted under US Environmental Protection Agency Cooperative Agreement (R-82808401) among the National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency and the Inner Mongolia Center for Endemic Disease Control and Research in Inner Mongolia, China. Other funders: US Environmental Protection Agency.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board of the University of North Carolina at Chapel Hill.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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