title: Manganese exposure through drinking water during pregnancy and size at birth: A prospective cohort study.
abstract: The essential element manganese (Mn) might be toxic at excess exposure. We assessed the impact of elevated Mn exposure through drinking water during pregnancy on birth size in a population-based cohort(n = 1695) in rural Bangladesh. Concentrations of water Mn (median = 236 μg/L, range = 7.1-6336; n = 1177) and erythrocyte Mn (median = 30 μg/kg, range = 6.3-114; n = 758) were measured using ICP-MS. In regression analyses, newborns of women in the highest tertile of water Mn (median = 1495 μg/L) were 0.49 cm (0.20 SD) shorter (B = -0.42; 95% CI: -0.77, -0.08) than those in the lowest tertile (56μg/L). The inverse association was significant in girls and also in boys of mothers with lowest hemoglobin values, likely due to higher absorption of Mn. Manganese concentrations in water and erythrocytes did not correlate, and the associations of the latter with birth size were less obvious. This study suggests that consumption of water with highly elevated Mn levels during pregnancy may impair fetal growth.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka 1000, Bangladesh.
authors.forename: Syed Moshfiqur
authors.initials: SM
authors.lastname: Rahman
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Kippler
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka 1000, Bangladesh.
authors.forename: Sultan
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
authors.forename: Brita
authors.initials: B
authors.lastname: Palm
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), GPO Box 128, Dhaka 1000, Bangladesh.
authors.forename: Shams
authors.initials: S
authors.lastname: El Arifeen
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden. Electronic address: marie.vahter@ki.se.
authors.forename: Marie
authors.initials: M
authors.lastname: Vahter
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D001724:Birth Weight; D001827:Body Height; D060766:Drinking Water / Q000032:analysis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008345:Manganese / Q000032:analysis* / Q000097:blood; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D011247:Pregnancy / Q000097:blood; D011446:Prospective Studies; D012424:Rural Population; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000097:blood; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D008345:Manganese
keywords: Birth length; Birth weight; Drinking water; Manganese toxicity; Pregnancy