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Published on: March 6, 2018
Investigating causal relation between prenatal arsenic exposure and birthweight: Are smaller infants more
Mohammad L Rahman1, Linda Valeri2, Molly L Kile3
1Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA.
Insights
Prenatal arsenic exposure lowers birthweight by shortening gestation in all infants. Smaller infants face higher risks due to arsenic exposure impacting growth, highlighting the need for exposure mitigation in Bangladesh.
Area of Science:
- Environmental Health
- Reproductive Health
- Toxicology
Background:
- Low birthweight is a significant global health concern, influenced by preterm birth and intrauterine growth restriction (IUGR).
- Prenatal exposure to arsenic has been associated with reduced birthweight, but the underlying causal mechanisms remain unclear.
Purpose of the Study:
- To investigate the association between prenatal arsenic exposure and birthweight, specifically examining the roles of shortened gestation and IUGR.
- To determine if the impact of arsenic exposure on birthweight differs across the spectrum of infant birth sizes.
Main Methods:
- A longitudinal birth cohort study in Bangladesh measured arsenic levels in drinking water and maternal toenails.
- Gestational age was determined by early ultrasound, and birthweight was recorded for 1184 singleton livebirths.
- Quantile causal mediation analysis was employed to assess arsenic's effects on birthweight through gestational length and other pathways.
Main Results:
- Prenatal arsenic exposure was negatively associated with birthweight, with effects varying by birthweight percentile.
- Arsenic's impact on birthweight mediated by shortened gestation affected all infants.
- Arsenic exposure through pathways independent of gestation primarily affected smaller infants, increasing their risk of low birthweight.
Conclusions:
- Infant size influences susceptibility to prenatal arsenic exposure, with smaller infants at greater risk.
- Arsenic exposure can lead to lower birthweight by reducing gestational duration and potentially causing growth restriction.
- Mitigating prenatal arsenic exposure is crucial for improving perinatal outcomes in populations like Bangladesh.
Background:
Shortening of gestation and intrauterine growth restriction (IUGR) are the two main determinants of birthweight. Low birthweight has been linked with prenatal arsenic exposure, but the causal relation between arsenic and birthweight is not well understood.
Objectives:
We applied a quantile causal mediation analysis approach to determine the association between prenatal arsenic exposure and birthweight in relation to shortening of gestation and IUGR, and whether the susceptibility of arsenic exposure varies by infant birth sizes.
Methods:
In a longitudinal birth cohort in Bangladesh, we measured arsenic in drinking water (n=1182) collected at enrollment and maternal toenails (n=1104) collected ≤1-month postpartum using inductively coupled plasma mass spectrometry. Gestational age was determined using ultrasound at ≤16weeks' gestation. Demographic information was collected using a structured questionnaire.
Results:
Of 1184 singleton livebirths, 16.4% (n=194) were low birthweight (<2500g), 21.9% (n=259) preterm (<37weeks' gestation), and 9.2% (n=109) both low birthweight and preterm. The median concentrations of arsenic in drinking water and maternal toenails were 2.2μg/L (range: below the level of detection [LOD]-1400) and 1.2μg/g (range:
Conclusions:
The susceptibility of prenatal arsenic exposure varied by infant birth sizes, placing smaller infants at greater risk of lower birthweight by shortening of gestation and possibly growth restriction. It is important to mitigate prenatal arsenic exposure to improve perinatal outcomes in Bangladesh.
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