School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Environment and Health Research Unit, Medical Research Council, Johannesburg, South Africa.
Lancet Laboratories, Department of Analytical Chemistry, Johannesburg, South Africa.
Sci Total Environ. 2017 Jan 1;575:338-346. doi: 10.1016/j.scitotenv.2016.10.044. Epub 2016 Oct 13.
Early life exposure to inorganic arsenic (iAs) has been shown to interfere with foetal and early childhood development, and is associated with morbidity and mortality in adulthood. The purpose of this study was to evaluate exposure to As in utero, to determine the association between maternal and cord blood of As and birth outcomes in South African populations. Total arsenic was measured in maternal blood of a total cohort (n=650) and in paired cord blood and urine of a subset cohort (n=317). Overall, the geometric mean (GM) of As in maternal blood was 0.62μg/L (n=650; 95% CI, 0.58-0.66). In the subset cohort, the GM of maternal blood As was 0.96μg/L (n=350; 95% CI, 0.91-1.02); in paired cord blood, the GM was 0.78μg/L (n=317; 95% CI, 0.74-0.83); and in urine (creatinine-corrected), the GM was 14.26μg/g creatinine (n=317; 95% CI, 12.64-16.09). A linear correlation was found between log maternal blood As and log cord blood As (rho=0.80, p<0.001). Birth outcomes showed geographical differences. in gestational age (p<0.001), birth length (p=0.019), head circumference (p<0.001), Apgar score at 5min (p<0.001) and parity (p<0.002). In a multivariate analysis, no association between maternal blood (AsB) levels and birth outcomes were found. However, the lower the gestational age, the higher the levels of maternal AsB (β=-0.054; 95% CI-0.087 to -0.020) and mothers who had had at least one child were less likely to have higher AsB if compared to those who had never had any child (β=-0.177; 95CI-0.322 to 0.031). In both univariate and multivariate analyses, being single, and drinking water from communal outdoor taps, boreholes and rivers was associated with higher As levels. The findings suggest that more research is needed to evaluate the impact of low level As exposure on postnatal development.
早期生活中接触无机砷（iAs）已被证明会干扰胎儿和儿童早期的发育，并与成年后的发病率和死亡率有关。本研究的目的是评估宫内砷暴露情况，以确定南非人群中母体和脐带血砷与出生结局之间的关系。在总队列（n=650）的母体血液中以及亚队列（n=317）的配对脐带血和尿液中测量总砷。总体而言，母体血液中砷的几何平均值（GM）为 0.62μg/L（n=650；95%置信区间，0.58-0.66）。在亚队列中，母体血液中砷的 GM 为 0.96μg/L（n=350；95%置信区间，0.91-1.02）；在配对脐带血中，GM 为 0.78μg/L（n=317；95%置信区间，0.74-0.83）；尿液（肌酐校正）中，GM 为 14.26μg/g 肌酐（n=317；95%置信区间，12.64-16.09）。发现母体血液中 log 砷与脐带血中 log 砷之间存在线性相关（rho=0.80，p<0.001）。出生结局显示出地理差异。在胎龄（p<0.001）、出生长度（p=0.019）、头围（p<0.001）、5 分钟时的 Apgar 评分（p<0.001）和产次（p<0.002）方面。在多变量分析中，未发现母体血液（AsB）水平与出生结局之间存在关联。然而，胎龄越低，母体 AsB 的水平越高（β=-0.054；95%置信区间-0.087 至-0.020），与从未生育过任何孩子的母亲相比，生育过至少一个孩子的母亲更不可能有更高的 AsB（β=-0.177；95CI-0.322 至 0.031）。在单变量和多变量分析中，单身以及饮用社区户外水龙头、水井和河流中的水与更高的砷水平有关。研究结果表明，需要进一步研究来评估低水平砷暴露对产后发育的影响。
