Health Department, Environmental Health Center Part of ALS, 58 Busuiocului Street, 400240, Cluj-Napoca, Romania; Faculty of Environmental Science and Engineering, Babes-Bolyai University, 30 Fantanele Street, 400294, Cluj-Napoca, Romania.
Department of Global and Community Health, George Mason University, 4400 University Dr, Fairfax, VA, United States.
Chemosphere. 2023 Sep;335:139167. doi: 10.1016/j.chemosphere.2023.139167. Epub 2023 Jun 7.
Arsenic occurs as a natural contaminant of drinking water supplies in arsenic endemic areas, posing a threat to public health. Our aim was to evaluate the relationship between urinary arsenic concentrations and spontaneous pregnancy loss in a population with low-moderate level drinking water arsenic exposure (mostly <10 μg/L). We enrolled 150 women with incident spontaneous pregnancy losses and 150 controls with ongoing pregnancies matched by gestational age. We measured arsenic species in urine using high performance liquid chromatography paired to inductively coupled plasma mass spectrometry. Urinary arsenic was not related to spontaneous pregnancy loss in conditional logistic regression models adjusted for confounding factors. However, a 10 μg/L increase in urinary arsenic (III + V) salt concentrations was associated with 8.00-fold (95% CI: 0.68, 3.35 × 10) greater odds of spontaneous loss among women using prenatal vitamins in an interaction model (P for interaction = 0.07), although the effect estimate was imprecise. In an additional interaction model, prenatal vitamin use was associated with lower odds of loss (OR = 0.30; 95% CI: 0.13, 0.66), although the association was diminished in the presence of a 10 μg/L increase in urinary inorganic arsenic (OR = 0.44; 95% CI: 0.70, 3.22). Total urinary arsenic was associated with 1.48-fold (95% CI: 0.20, 11.35) greater odds for loss among women with urinary cotinine >50 μg/L in another interaction model (P for interaction = 0.07). These results suggest a potential modest increase in the odds of pregnancy loss associated with increased total urinary arsenic among women smoking during pregnancy (urinary cotinine >50 μg/L). Prenatal vitamin use may act as a protective factor for arsenic exposure associated pregnancy loss, but appears to be less protective with increasing urinary inorganic arsenic concentrations.
砷是饮用水中自然存在的污染物，在砷流行地区对公共健康构成威胁。我们的目的是评估低-中度饮用水砷暴露（大多<10μg/L）人群中尿砷浓度与自然流产之间的关系。我们招募了 150 名有自然流产史的女性和 150 名匹配孕周的继续妊娠的对照。我们使用高效液相色谱法与电感耦合等离子体质谱法联用测定尿砷。在调整混杂因素的条件逻辑回归模型中，尿砷与自然流产无相关性。然而，在使用产前维生素的女性中，尿砷（III+V）盐浓度增加 10μg/L 与自然流产的风险增加 8.00 倍（95%CI：0.68，3.35×10）有关，交互模型中 P 值为 0.07），尽管效应估计值不精确。在另一个交互模型中，产前维生素的使用与较低的流产风险相关（OR=0.30；95%CI：0.13，0.66），但在尿无机砷增加 10μg/L 的情况下，这种关联减弱（OR=0.44；95%CI：0.70，3.22）。在另一个交互模型中，尿可替宁>50μg/L 的女性中，总尿砷与流产风险增加 1.48 倍相关（95%CI：0.20，11.35），交互模型中 P 值为 0.07。这些结果表明，在怀孕期间吸烟（尿可替宁>50μg/L）的女性中，总尿砷增加与流产风险增加之间存在潜在的适度关联。产前维生素的使用可能是砷暴露相关流产的保护因素，但随着尿无机砷浓度的增加，其保护作用似乎降低。
