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

Y1 - 2022

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

U2 - 10.1016/j.envint.2021.107051

DO - 10.1016/j.envint.2021.107051

M3 - Journal article

C2 - 34942407

AN - SCOPUS:85121466545

VL - 160

JO - Environment international

JF - Environment international

SN - 0160-4120

M1 - 107051

ER -