TY - JOUR
T1 - Maternal exposure to arsenic in drinking water and risk of congenital heart disease in the offspring
AU - Richter, Frida
AU - Kloster, Stine
AU - Wodschow, Kirstine
AU - Hansen, Birgitte
AU - Schullehner, Jörg
AU - Kristiansen, Søren Munch
AU - Petersen, Mette Mains
AU - Strandberg-Larsen, Katrine
AU - Ersbøll, Annette Kjær
N1 - Publisher Copyright:
© 2021
PY - 2022/2
Y1 - 2022/2
N2 - Introduction: Prenatal exposure to arsenic is suspected to impair fetal health, including congenital malformations. Few studies investigated an association between maternal exposure to arsenic and congenital heart disease. Objective: To examine the association between maternal exposure to arsenic through drinking water and congenital heart disease among offspring.Methods: This nationwide cohort study included all liveborn children in Denmark, 1997–2014. Maternal addresses at fetal age 4 weeks were linked to drinking water supply areas. Exposure was arsenic concentration in drinking water in first trimester in four categories (<0.5 μg/L, 0.5–0.9 μg/L, 1.0–4.9 μg/L, ≥5.0 μg/L). Outcomes were defined as congenital heart disease diagnosed within the first year of life, with sub-categorization of severe, septal defects and valvular heart defect. Associations between arsenic levels and congenital heart disease were analysed using logistic regression, presented as odds ratios (OR) with 95% confidence interval (CI), and adjusted for year of birth, mother's educational level and ethnicity. Results: A total of 1,042,413 liveborn children were included of whom 1.0% had a congenital heart disease. The OR of congenital heart disease was higher among children exposed to all levels of arsenic above 0.5 μg/L; the OR was 1.13 (95% CI: 1.08–1.19) for exposure of 0.5–0.9 μg/L, 1.33 (95% CI: 1.27–1.39) for 1.0–4.9 μg/L and 1.42 (95% CI: 1.24–1.63) for ≥5.0 μg/L. Similar associations were observed for congenital septal defects. The OR was also higher for severe congenital heart disease but at the same level among all exposure levels ≥0.5 μg/L. The OR of congenital valvular heart defects was only higher among children with maternal exposure to arsenic in drinking water ≥5.0 μg/L. The associations were similar for boys and girls. Conclusion: The findings indicate that maternal exposure to arsenic in drinking water even at low concentrations (i.e., 0.5–0.9 μg/L) increased the risk of congenital heart disease in the offspring.
AB - Introduction: Prenatal exposure to arsenic is suspected to impair fetal health, including congenital malformations. Few studies investigated an association between maternal exposure to arsenic and congenital heart disease. Objective: To examine the association between maternal exposure to arsenic through drinking water and congenital heart disease among offspring.Methods: This nationwide cohort study included all liveborn children in Denmark, 1997–2014. Maternal addresses at fetal age 4 weeks were linked to drinking water supply areas. Exposure was arsenic concentration in drinking water in first trimester in four categories (<0.5 μg/L, 0.5–0.9 μg/L, 1.0–4.9 μg/L, ≥5.0 μg/L). Outcomes were defined as congenital heart disease diagnosed within the first year of life, with sub-categorization of severe, septal defects and valvular heart defect. Associations between arsenic levels and congenital heart disease were analysed using logistic regression, presented as odds ratios (OR) with 95% confidence interval (CI), and adjusted for year of birth, mother's educational level and ethnicity. Results: A total of 1,042,413 liveborn children were included of whom 1.0% had a congenital heart disease. The OR of congenital heart disease was higher among children exposed to all levels of arsenic above 0.5 μg/L; the OR was 1.13 (95% CI: 1.08–1.19) for exposure of 0.5–0.9 μg/L, 1.33 (95% CI: 1.27–1.39) for 1.0–4.9 μg/L and 1.42 (95% CI: 1.24–1.63) for ≥5.0 μg/L. Similar associations were observed for congenital septal defects. The OR was also higher for severe congenital heart disease but at the same level among all exposure levels ≥0.5 μg/L. The OR of congenital valvular heart defects was only higher among children with maternal exposure to arsenic in drinking water ≥5.0 μg/L. The associations were similar for boys and girls. Conclusion: The findings indicate that maternal exposure to arsenic in drinking water even at low concentrations (i.e., 0.5–0.9 μg/L) increased the risk of congenital heart disease in the offspring.
KW - Arsenic
KW - Congenital heart disease
KW - Drinking water
KW - Maternal exposure
KW - Population-based individual-level registers
KW - Prenatal
UR - http://www.scopus.com/inward/record.url?scp=85121466545&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2021.107051
DO - 10.1016/j.envint.2021.107051
M3 - Article
AN - SCOPUS:85121466545
SN - 0160-4120
VL - 160
JO - Environment International
JF - Environment International
M1 - 107051
ER -
