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American Journal of Epidemiology Advance Access published online on November 26, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn332
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Arsenic Exposure During Pregnancy and Size at Birth: A Prospective Cohort Study in Bangladesh

Anisur Rahman, Marie Vahter, Allan H. Smith, Barbro Nermell, Mohammed Yunus, Shams El Arifeen, Lars-Åke Persson and Eva-Charlotte Ekström

Correspondence to Dr. Anisur Rahman, International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, University Hospital, SE-75185 Uppsala, Sweden (e-mail: anisur.rahman{at}kbh.uu.se).

Received for publication May 21, 2008. Accepted for publication September 18, 2008.

The authors evaluated the association of prenatal arsenic exposure with size at birth (birth weight, birth length, head and chest circumferences). This prospective cohort study, based on 1,578 mother-infant pairs, was conducted in Matlab, Bangladesh, in 2002–2003. Arsenic exposure was assessed by analysis of arsenic in urine collected at around gestational weeks 8 and 30. The association of arsenic exposure with size at birth was assessed by linear regression analyses. In analysis over the full range of exposure (6–978 µg/L), no dose-effect association was found with birth size. However, significant negative dose effects were found with birth weight and head and chest circumferences at a low level of arsenic exposure (<100 µg/L in urine). In this range of exposure, birth weight decreased by 1.68 (standard error (SE), 0.62) g for each 1-µg/L increase of arsenic in urine. For head and chest circumferences, the corresponding reductions were 0.05 (SE, 0.03) mm and 0.14 (SE, 0.03) mm per 1 µg/L, respectively. No further negative effects were shown at higher levels of arsenic exposure. The indicated negative effect on birth size at a low level of arsenic exposure warrants further investigation.

arsenic; Bangladesh; birth weight; cohort studies; maternal exposure; urine

Abbreviations: GW, gestational week; HDSS, health and demographic surveillance system; ICDDR,B, International Centre for Diarrhoeal Disease Research, Bangladesh; MINIMat, Maternal and Infant Nutrition Interventions, Matlab; SD, standard deviation; SE, standard error


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