Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Environ Pollut. 2018 May;236:817-823. doi: 10.1016/j.envpol.2018.02.012.
Maternal arsenic exposure leads to adverse birth outcomes, but the critical window of this susceptibility keeps unclear. To determine whether the associations between maternal arsenic exposure and birth outcomes were trimester-specific, we conducted a birth cohort study of 1390 women from 2014 to 2016 in Wuhan, China. We examined associations between total urinary arsenic concentrations in three trimesters and birth weight, birth length and the risk of small for gestational age (SGA), and the differences of these associations across trimesters using generalized estimating equations. Maternal urinary arsenic concentrations varied across trimesters and were weakly correlated. Arsenic concentrations in the 3rd trimester, but not in the 1st and 2nd trimesters, were associated with birth outcomes. For each doubling of arsenic levels in the 3rd trimester, birth weight was decreased 24.27 g (95% confidence interval (CI): -46.99, -1.55), birth length was decreased 0.13 cm (95% CI: -0.22, -0.04), and the risk for SGA birth was increased 25% (95% CI: 1.03, 1.49). Further, stratified analyses indicated that these associations were only observed in female infants. Our findings indicate maternal arsenic levels in the 3rd trimester seemed to have significant impacts on birth outcomes, and also emphasize the public health interventions relevance to arsenic exposure in late pregnancy.
母体砷暴露会导致不良的出生结局，但这种易感性的关键窗口期尚不清楚。为了确定母体砷暴露与出生结局之间是否存在特定于妊娠阶段的关联，我们在中国武汉进行了一项 2014 年至 2016 年期间的 1390 名女性的出生队列研究。我们使用广义估计方程，检验了三个妊娠阶段的总尿砷浓度与出生体重、出生长度和小于胎龄儿（SGA）风险之间的关系，以及这些关联在妊娠阶段之间的差异。母体尿砷浓度在妊娠阶段之间存在差异且相关性较弱。第三阶段的砷浓度，而不是第一和第二阶段的砷浓度，与出生结局有关。第三阶段的砷水平每增加一倍，出生体重就会降低 24.27 克（95%置信区间：-46.99，-1.55），出生长度就会降低 0.13 厘米（95%置信区间：-0.22，-0.04），SGA 出生的风险增加 25%（95%置信区间：1.03，1.49）。此外，分层分析表明，这些关联仅在女性婴儿中观察到。我们的研究结果表明，妊娠晚期母体砷水平似乎对出生结局有显著影响，这也强调了针对妊娠晚期砷暴露的公共卫生干预的相关性。
