Maternal arsenic exposure and birth outcomes: A birth cohort study in Wuhan, China

Environ Pollut. 2018 May;236:817-823. doi: 10.1016/j.envpol.2018.02.012.


Maternal arsenic exposure leads to adverse birth outcomes, but the critical window of this susceptibility keeps unclear. To determine whether the associations between maternal arsenic exposure and birth outcomes were trimester-specific, we conducted a birth cohort study of 1390 women from 2014 to 2016 in Wuhan, China. We examined associations between total urinary arsenic concentrations in three trimesters and birth weight, birth length and the risk of small for gestational age (SGA), and the differences of these associations across trimesters using generalized estimating equations. Maternal urinary arsenic concentrations varied across trimesters and were weakly correlated. Arsenic concentrations in the 3rd trimester, but not in the 1st and 2nd trimesters, were associated with birth outcomes. For each doubling of arsenic levels in the 3rd trimester, birth weight was decreased 24.27 g (95% confidence interval (CI): -46.99, -1.55), birth length was decreased 0.13 cm (95% CI: -0.22, -0.04), and the risk for SGA birth was increased 25% (95% CI: 1.03, 1.49). Further, stratified analyses indicated that these associations were only observed in female infants. Our findings indicate maternal arsenic levels in the 3rd trimester seemed to have significant impacts on birth outcomes, and also emphasize the public health interventions relevance to arsenic exposure in late pregnancy.

Keywords: Cohort; Critical window; Low-level arsenic; Sex specific; Urine.

MeSH terms

  • Adult
  • Arsenic / metabolism*
  • Arsenic / toxicity
  • Birth Weight
  • China / epidemiology
  • Cohort Studies
  • Environmental Pollutants / metabolism*
  • Environmental Pollutants / toxicity
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Maternal Exposure / adverse effects
  • Maternal Exposure / statistics & numerical data*
  • Pregnancy
  • Pregnancy Outcome / epidemiology*


  • Environmental Pollutants
  • Arsenic