Milton Abul H, Hussain Sumaira, Akter Shahnaz, Rahman Mijanur, Mouly Tafzila A, Mitchell Kane
Centre for Clinical Epidemiology and Biostatistics (CCEB), School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
Mercy Corps, Pak Palace, Murree Road, Rawal Chowk, Islamabad 44000, Pakistan.
Int J Environ Res Public Health. 2017 May 23;14(6):556. doi: 10.3390/ijerph14060556.
Exposure to arsenic has a number of known detrimental health effects but impact on pregnancy outcomes is not as widely recognized. This narrative review examines existing epidemiological evidence investigating the association between arsenic exposure via drinking water and adverse pregnancy outcomes. We reviewed published epidemiological studies from around the world on impact of chronic arsenic exposure on spontaneous abortion, stillbirth, neonatal death, post neonatal death, low birth weight and preterm baby. Plausible mechanisms of arsenic toxicity causing adverse pregnancy outcomes were also determined through literature review. There is convincing evidence to support the association between high inorganic arsenic exposure (>50 ppb) and spontaneous abortion, stillbirth and low birth weight. Limitations of certain studies include study design, small sample size, recall constraints and exposure assessment. There needs to be further research investigating the dose metered impact of arsenic exposure on pregnancy outcomes. Further research on impact of low-moderate arsenic concentration exposure on pregnancy outcomes will allow for appropriate public health policy recommendations.
接触砷会对健康产生许多已知的有害影响，但对妊娠结局的影响尚未得到广泛认可。本叙述性综述考察了现有的流行病学证据，以研究通过饮用水接触砷与不良妊娠结局之间的关联。我们回顾了世界各地发表的关于慢性砷暴露对自然流产、死产、新生儿死亡、新生儿后期死亡、低出生体重和早产影响的流行病学研究。通过文献综述还确定了砷毒性导致不良妊娠结局的合理机制。有令人信服的证据支持高无机砷暴露（>50 ppb）与自然流产、死产和低出生体重之间的关联。某些研究的局限性包括研究设计、样本量小、回忆偏倚和暴露评估。需要进一步研究砷暴露对妊娠结局的剂量效应。对低中度砷浓度暴露对妊娠结局影响的进一步研究将有助于提出适当的公共卫生政策建议。
