title: Pregnancy outcomes, infant mortality, and arsenic in drinking water in West Bengal, India.
abstract: Between 2001 and 2003, the authors studied pregnancy outcomes and infant mortality among 202 married women in West Bengal, India. Reproductive histories were ascertained using structured interviews. Arsenic exposure during each pregnancy, including all water sources used, was assessed; this involved measurements from 409 wells. Odds ratios for spontaneous abortion, stillbirth, neonatal mortality, and infant mortality were estimated with logistic regression based on the method of generalized estimating equations. Exposure to high concentrations of arsenic (> or =200 microg/liter) during pregnancy was associated with a sixfold increased risk of stillbirth after adjustment for potential confounders (odds ratio (OR) = 6.07, 95% confidence interval (CI): 1.54, 24.0; p = 0.01). Arsenic-related skin lesions were found in 12 women who had a substantially increased risk of stillbirth (OR = 13.1, 95% CI: 3.17, 54.0; p = 0.002). The odds ratio for neonatal death was 2.81 (95% CI: 0.73, 10.8). No association was found between arsenic exposure and spontaneous abortion (OR = 1.01, 95% CI: 0.38, 2.70) or overall infant mortality (OR = 1.33, 95% CI: 0.43, 4.04). This study adds to the limited evidence that exposure to high concentrations of arsenic during pregnancy increases the risk of stillbirth. However, there was no indication of the increased rates of spontaneous abortion and overall infant mortality that have been reported in some studies.
authors.affiliation: School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
authors.forename: O S
authors.initials: OS
authors.lastname: von Ehrenstein
authors.forename: D N
authors.initials: DN
authors.lastname: Guha Mazumder
authors.forename: M
authors.initials: M
authors.lastname: Hira-Smith
authors.forename: N
authors.initials: N
authors.lastname: Ghosh
authors.forename: Y
authors.initials: Y
authors.lastname: Yuan
authors.forename: G
authors.initials: G
authors.lastname: Windham
authors.forename: A
authors.initials: A
authors.lastname: Ghosh
authors.forename: R
authors.initials: R
authors.lastname: Haque
authors.forename: S
authors.initials: S
authors.lastname: Lahiri
authors.forename: D
authors.initials: D
authors.lastname: Kalman
authors.forename: S
authors.initials: S
authors.lastname: Das
authors.forename: A H
authors.initials: AH
authors.lastname: Smith
mesh_terms: D020261:Arsenic Poisoning / Q000150:complications* / Q000453:epidemiology*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007407:Interviews as Topic; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D014874:Water Pollutants, Chemical / Q000032:analysis*
chemical_list: D014874:Water Pollutants, Chemical