Fano-Sizgorich Diego, Vásquez-Velásquez Cinthya, Yucra Sandra, Vásquez Vanessa, Tokeshi Patricio, Aguilar Julio, Ramírez-Atencio Claudio, Barr Dana Boyd, Gonzales Gustavo F
Laboratory of Endocrinology and Reproduction, Universidad Peruana Cayetano Heredia, Lima, Lima 31, Peru.
Universidad Nacional Jorge Basadre Grohmann, Tacna, Peru.
Expo Health. 2021 Mar;13(1):133-140. doi: 10.1007/s12403-020-00377-2. Epub 2020 Sep 1.
Inorganic arsenic exposure has been linked to the development of several health conditions, including adverse birth outcomes; and around 150 million of people worldwide are exposed to levels above the WHO suggested limit of 10 μg/L. A recent risk assessment in pregnant women of Tacna, of this same population performed by our group, found that 70.25% were exposed to arsenic concentrations in drinking water ≥25 μg/L. The present study aimed to evaluate the relationship between prenatal total urinary arsenic (U-tAs) and inorganic arsenic (U-iAs) with adverse birth outcomes. A total of 147 pregnant women from the province of Tacna, Peru, during February - March, 2019, were evaluated for U-tAs and U-iAs exposure during their second trimester of pregnancy, while the birth records of their children were collected from the local hospital. The geometric mean U-tAs was 43.97 ± 25.88 μg/L (P 22.30, range 5.99 - 181.94 μg/L) and U-iAs was 5.27 ± 2.91 μg/L. Controlling for maternal age, pre-pregnancy BMI, parity, mother's education and newborn sex, no relationship was observed between tertile of U-tAs and the birth outcomes considered, although we found an apparent but statistically non-significant dose-response relationship for small-for-gestational-age 2.38% ( 95% CI 0.003, 0.16), versus 7.32% (95% CI 0.02, 0.21%), versus 8.57% (0.03, 0.25%). This finding requires further evaluation considering other factors such as metabolic arsenic species, additional maternal covariates and ethnicity.
无机砷暴露与多种健康问题的发生有关，包括不良出生结局；全球约有1.5亿人暴露于超过世界卫生组织建议的10μg/L限值的水平。我们团队对同一人群的塔克纳孕妇进行的一项近期风险评估发现，70.25%的孕妇饮用水中的砷浓度≥25μg/L。本研究旨在评估产前尿总砷（U-tAs）和无机砷（U-iAs）与不良出生结局之间的关系。2019年2月至3月期间，对秘鲁塔克纳省的147名孕妇在妊娠中期进行了U-tAs和U-iAs暴露评估，同时从当地医院收集了她们孩子的出生记录。尿总砷的几何平均值为43.97±25.88μg/L（P 22.30，范围5.99 - 181.94μg/L），无机砷为5.27±2.91μg/L。在控制了产妇年龄、孕前体重指数、产次、母亲教育程度和新生儿性别后，未观察到尿总砷三分位数与所考虑的出生结局之间存在关联，尽管我们发现小于胎龄儿存在明显但无统计学意义的剂量反应关系，分别为2.38%（95%CI 0.003，0.16）、7.32%（95%CI 0.02，0.21%）、8.57%（0.03，0.25%）。考虑到其他因素，如代谢砷物种、额外的产妇协变量和种族，这一发现需要进一步评估。
