Preliminary analysis of in utero low-level arsenic exposure and fetal growth using biometric measurements extracted from fetal ultrasound reports

Abstract

BackgroundEarly life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero.MethodsUsing a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation.ResultsIn a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value < 0.05). Although, associations were attenuated in adjusted analyses — among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: -0.151, 0.007) decrease in biparietal head diameter Z-score.ConclusionsOur study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-14-12) contains supplementary material, which is available to authorized users.

Embryonic-only arsenic exposure in killifish (Fundulus heteroclitus) reduces growth and alters muscle IGF levels one year later

“…Similar to our findings, several epidemiological studies have noted that embryonic arsenic exposures from maternal drinking water reduces birth weight and weight gain in children (Bloom et al, 2014; Davis et al, 2015; Hopenhayn et al, 2003; Kile et al, 2016). For example, children born to mothers in arsenic-exposed villages in Taiwan were 29g lighter than those from non-exposed villages (Yang et al , 2003).…”

Maternal and infant inflammatory markers in relation to prenatal arsenic exposure in a U.S. pregnancy cohort

“…49–51 Some have speculated that As’s vascular impacts could affect the placenta by leading to placental insufficiency and intrauterine growth retardation, thus potentially underlying As-related effects on fetal growth and birth weight. 57–61 While it is unclear whether As-related changes in a mother’s vascular health may affect her child’s health, our structural equation models suggest that As’s effects on biomarkers of maternal endothelial function may in turn mediate similar changes in these same biomarkers in infants. Nonetheless, the long-term impacts of these changes have yet to be explored.…”

Low level arsenic contaminated water consumption and birth outcomes in Romania—An exploratory study

“…Still, given the novelty of this result additional confirmation is necessary and so we are reluctant to speculate with respect to biologic mechanism. U.S. investigators recently reported that smaller head size on ultrasound was associated with higher maternal urine iAs for girls, but not for boys, in a New Hampshire population with exposure to 0 – 9.3 μg/L drinking water iAs [84]. Thus sex-specific vulnerabilities may be important to the impact of iAs on growth in utero .…”