title: In utero arsenic exposure and infant infection in a United States cohort: a prospective study.
abstract: Arsenic (As), a ubiquitous environmental toxicant, has recently been linked to disrupted immune function and enhanced infection susceptibility in highly exposed populations. In drinking water, as levels above the EPA maximum contaminant level occur in our US study area and are a particular health concern for pregnant women and infants. As a part of the New Hampshire Birth Cohort Study, we investigated whether in utero exposure to As affects risk of infant infections. We prospectively obtained information on 4-month-old infants (n=214) using a parental telephone survey on infant infections and symptoms, including respiratory infections, diarrhea and specific illnesses, as well as the duration and severity of infections. Using logistic regression and Poisson models, we evaluated the association between maternal urinary As during pregnancy and infection risks adjusted for potentially confounding factors. Maternal urinary As concentrations were related to total number of infections requiring a physician visit (relative risk (RR) per one-fold increase in As in urine=1.5; 95% confidence interval (CI)=1.0, 2.1) or prescription medication (RR=1.6; 95% CI=1.1, 2.4), as well as lower respiratory infections treated with prescription medication (RR=3.3; 95% CI=1.2, 9.0). Associations were observed with respiratory symptoms (RR=4.0; 95% CI=1.0, 15.8), upper respiratory infections (RR=1.6; 95% CI=1.0, 2.5), and colds treated with prescription medication (RR=2.3; 95% CI=1.0, 5.2). Our results provide initial evidence that in utero As exposure may be related to infant infection and infection severity and provide insight into the early life impacts of fetal As exposure.
authors.affiliation: Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH 03755, USA; Section of Biostatistics and Epidemiology, Department of Community and Family Medicine and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.
authors.forename: Shohreh F
authors.initials: SF
authors.lastname: Farzan
authors.forename: Susan
authors.initials: S
authors.lastname: Korrick
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.forename: Richard
authors.initials: R
authors.lastname: Enelow
authors.forename: A Jay
authors.initials: AJ
authors.lastname: Gandolfi
authors.forename: Juliette
authors.initials: J
authors.lastname: Madan
authors.forename: Kari
authors.initials: K
authors.lastname: Nadeau
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
mesh_terms: D000328:Adult; D001151:Arsenic / Q000633:toxicity* / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D011247:Pregnancy / Q000652:urine; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies; D014874:Water Pollutants, Chemical / Q000633:toxicity / Q000652:urine; D055815:Young Adult
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic
keywords: Arsenic; As; EPA; Environmental Protection Agency; Infant respiratory infection; MCL; NHBCS; New Hampshire Birth Cohort Study; Pregnancy; Prenatal exposure; US cohort; arsenic; maximum contaminant level