title: Blood Pressure Changes in Relation to Arsenic Exposure in a U.S. Pregnancy Cohort.
abstract: BACKGROUND
  Inorganic arsenic exposure has been related to the risk of increased blood pressure based largely on cross-sectional studies conducted in highly exposed populations. Pregnancy is a period of particular vulnerability to environmental insults. However, little is known about the cardiovascular impacts of arsenic exposure during pregnancy.
  
  
  OBJECTIVE
  We evaluated the association between prenatal arsenic exposure and maternal blood pressure over the course of pregnancy in a U.S.
  
  
  METHODS
  The New Hampshire Birth Cohort Study is an ongoing prospective cohort study in which > 10% of participant household wells exceed the arsenic maximum contaminant level of 10 μg/L established by the U.S. EPA. Total urinary arsenic measured at 24-28 weeks gestation was measured and used as a biomarker of exposure during pregnancy in 514 pregnant women, 18-45 years of age, who used a private well in their household. Outcomes were repeated blood pressure measurements (systolic, diastolic, and pulse pressure) recorded during pregnancy.
  
  
  RESULTS
  Using linear mixed effects models, we estimated that, on average, each 5-μg/L increase in urinary arsenic was associated with a 0.15-mmHg (95% CI: 0.02, 0.29; p = 0.022) increase in systolic blood pressure per month and a 0.14-mmHg (95% CI: 0.02, 0.25; p = 0.021) increase in pulse pressure per month over the course of pregnancy.
  
  
  CONCLUSIONS
  In our U.S. cohort of pregnant women, arsenic exposure was associated with greater increases in blood pressure over the course of pregnancy. These findings may have important implications because even modest increases in blood pressure impact cardiovascular disease risk.
authors: Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Hanover, New Hampshire, USA.
authors: Shohreh F
authors: SF
authors: Farzan
authors: Yu
authors: Y
authors: Chen
authors: Fen
authors: F
authors: Wu
authors: Jieying
authors: J
authors: Jiang
authors: Mengling
authors: M
authors: Liu
authors: Emily
authors: E
authors: Baker
authors: Susan A
authors: SA
authors: Korrick
authors: Margaret R
authors: MR
authors: Karagas
mesh_terms: D000293:Adolescent; D000328:Adult; D001151:Arsenic / Q000652:urine*; D001794:Blood Pressure; D060766:Drinking Water / Q000032:analysis*; D005260:Female; D006801:Humans; D018811:Maternal Exposure; D009513:New Hampshire; D011247:Pregnancy; D011446:Prospective Studies; D014874:Water Pollutants, Chemical / Q000652:urine*; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D001151:Arsenic