Fei et al. 2013a,b (PCO) |
New Hamsphire (USA) |
133 pregnant women |
Arsenic levels in urine |
NA |
Not reported |
Birth weight |
Infant sex, maternal age, gestational age |
7/9 |
Guan et al. 2012b,c (CS) |
Dalian (China) |
125 mother–infant pairs |
Arsenic levels in maternal and cord blood |
Arsenic-affected area (590 μg/L) vs. arsenic-free area |
Not reported |
Birth weight |
Maternal age, BMI, parity, gestational age at delivery, maternal education, maternal secondhand smoke exposure, infant sex |
5/9 |
Cherry et al. 2010c,d (RCO) |
Gonoshasthaya Kendra villages (Bangladesh) |
934 infant mortality occurring in designated area, 2001–2003 |
Arsenic levels in tube-well water |
≥ 50 μg/L vs. < 10 μg/L |
0.05–166 μg/L |
Infant mortality |
First pregnancies, others with no formal education, mothers designated as destitute |
7/9 |
Myers et al. 2010c,d (RCO) |
Bayingnormen (Mongolia, China) |
9,890 singleton deliveries of mothers |
Arsenic levels in tube-well water |
> 50 μg/L vs. ≤ 50 μg/L |
UD–1,200 μg/L |
Birth weight, preterm delivery, stillbirth, and neonatal mortality |
Maternal age, gravidity, infant sex for the analysis of birth weight and maternal age, gravidity, infant sex adequacy for the analysis of preterm delivery, stillbirth, and neonatal mortality |
7/9 |
Rahman et al. 2010b,c (PCO) |
Matlab district (Bangladesh) |
2,924 pregnant women |
Arsenic levels in urine |
249–1,253 μg/L vs. < 33 μg/L (spontaneous abortion)268–2,019 μg/L vs. < 38 μg/L (stillbirth)268–2,019 vs. < 38 μg/L (infant mortality) |
UD–1,253 μg/L |
Spontaneous abortion, stillbirth, infant mortality |
No significant confounder was found |
7/9 |
Rahman et al. 2009b,c (PCO) |
Matlab (Bangladesh) |
1,578 women with single births |
Arsenic concentrations in urine |
≥ 100 μg/L vs. < 100 μg/L |
6–978 μg/L |
Birth weight |
Asset score, BMI, height, age, education, season, gestational age at birth, sex of infant |
8/9 |
Cherry et al. 2008c,d (RCO) |
Villages in 13 subdistricts (Bangladesh) |
30,984 pregnancies and outcomes |
Average arsenic concentrations in hand-pumped well water |
≥ 50 μg/L vs. < 0.10 μg/L |
UD–81 μg/L |
Stillbirth |
Age, sex, previous pregnancy, previous stillbirth, low socioeconomic status, maternal education, paternal education, maternal smoking, mother high BP, mother edema, gestational age, birth weight, home delivery |
8/9 |
Sen and Chaudhuri 2008c,d,e (CS) |
Villages located in North 24 Parganas district (states of West Bengal) |
Pregnancy outcomes of 240 married women |
Arsenic levels in tube-well water |
600 μg/L vs. < 10 μg/L |
10–600 μg/L |
Spontaneous abortion and stillbirth |
None |
2/9 |
Huyck et al. 2007b,c (PCO) |
42 villages in Sirajdikhan Upakila of Munshigani district (Bangladesh) |
49 women ≥ 18 years of age |
Arsenic levels in maternal hair at first visit |
≥ 2.70 μg/g vs. < 0.28 μg/g |
0.14–3.28 μg/g |
Birth weight |
Gestational age at first prenatal visit, maternal weight gain, birth gestational age, and activity level during pregnancy |
7/9 |
Rahman et al. 2007c,d (PCO) |
Matlab (Bangladesh) |
29,134 pregnancies identified by the HDSS in 1991–2000 |
Arsenic levels in tube-well water |
≥ 409 μg/L vs. < 10 μg/L |
Median, 224 μg/L |
Fetal loss, infant mortality, neonatal |
Age, parity, education, and socioeconomic status |
7/9 |
Ahamed et al. 2006a, 2006bc,d,e (CS) |
Eruani village (Bangladesh) |
56 pregnancy outcomes in women of reproductive age |
Arsenic levels in tube-well water |
Exposed area (501–1,200 μg/L) vs. control area |
501–1,200 μg/L |
Spontaneous abortion and stillbirth |
None |
1/9 |
von Ehrenstein et al. 2006c,d (CS) |
21 villages in West Bengali (south 24-Parganas district) (India) |
202 married women, 20–40 years of age |
Arsenic levels in tube-well water |
≥ 200 μg/L vs. < 50 μg/L |
Mean = 101.7 μg/L |
Spontaneous abortion, stillbirth, neonatal mortality, infant mortality |
Mother’s age at child’s birth, BMI, maternal education, education of the head of the household, and type of housing material |
3/9 |
Milton et al. 2005c,d (CS) |
29 villages in Comilla district, 2 villages in the Chandpur district, 43 villages in the Chaudanga district (Bangladesh) |
533 ever-married women, 15–49 years of age |
Arsenic levels in tube-well water |
> 50 μg/L vs. ≤ 50 μg/L |
UD–1,710 μg/L |
Spontaneous abortion, stillbirth, and neonatal mortality |
Height, history of hypertension and diabetes, and age at first pregnancy for neonatal mortality |
3/9 |
Mukherjee et al. 2005c,d,e (CS) |
Murshidabad (West Bengal, India) |
17 married women of reproductive age (18–40 years) with at least 1 pregnancy |
Arsenic levels in drinking water |
Exposed area (401–1,474 μg/L) vs. nonexposed area (< 3 μg/L) |
401–1,474 μg/L |
Spontaneous abortion and stillbirth |
None |
1/9 |
Rahman et al. 2005c,d,e (CS) |
Jalangi block (India) |
13 married women of reproductive age (18–40 years) |
Arsenic levels in drinking water |
Women in exposed areas (501–1,474 μg/L) vs. women in control area (< 10 μg/L) |
Not reported |
Spontaneous abortion and stillbirth |
None |
1/9 |
Chakraborti et al. 2003c,d,e (CS) |
Semria Ojha Patti village of Ara (Bhoipur, India) |
16 women |
Arsenic levels in tubes-well water |
463–1,025 μg/L vs. 7–39 μg/L |
7–1,025 μg/L |
Stillbirth |
None |
1/9 |
Guo et al. 2003a,d (CS) |
Villages in Wuyan County (Inner Mongolia, China) |
224 women |
Arsenic levels in well water |
Exposed area (43 μg/L) vs. nonexposed area (9.6 μg/L) |
Not reported |
Spontaneous abortion |
Sex, age, smoking and alcohol consumption |
3/9 |
Hopenhayn et al. 2003a,d (PCO) |
Antofagasta and Valparaiso (Chile) |
844 singleton mothers 18–45 years of age |
Arsenic levels in water |
40 μg/L vs. < 1 μg/L |
32.9–52.7 μg/L |
Birth weight |
Location, calendar time, arsenic exposure |
6/9 |
Yang et al. 2003a,d (RCO) |
18 villages in 4 township in Lanyang Basin (Taiwan) |
18,259 singleton births |
High arsenic–exposed community used as a surrogate |
Exposed area (UD–3,590 μg/L) vs. nonexposed area |
UD–3.59 ppm |
Preterm delivery, birth weight |
Maternal age, marital status, maternal education, infant sex |
6/9 |
Ahmad et al. 2001c,d (CS) |
Village of Samta in thana Sharsha, Jessore district; village of Katiarchar in Sadar thana, Kishorgonj district (Bangladesh) |
192 married women of reproductive age (15–49 years) |
Arsenic levels in tube-well water |
> 50 μg/L vs. ≤ 0.2 μg/L |
200–450 μg/L |
Spontaneous abortion, stillbirth, and preterm birth |
Socioeconomic status, education, and age at marriage |
3/9 |
Hopenhayn-Rich et al. 2000c,d (RCO) |
Antofagasta and Valparaiso (Chile) |
Mortality of infants, 1950–1996 |
Arsenic levels in public water |
> 50 vs. 5 μg/L |
40–860 μg/L |
Fetal mortality, neonatal mortality, |
Location, calendar time, arsenic exposure |
6/9 |
Ihrig et al. 1998c,d (C‑;C) |
Bryan, TX (USA) |
119 case babies, and 267 control babies |
Arsenic levels estimated from airborne emissions |
> 100 vs. 0 ng/m3
|
Not reported |
Stillbirths |
Maternal age, race/ethnicity, parity, income group, exposure as a categorical variable, and exposure–race/ethnicity interaction |
7/9 |
Aschengrau et al. 1989 (C-C)a,d
|
Boston, MA (USA) |
286 cases, 1,391 controls |
Arsenic levels in public drinking water |
1.4–1.9 μg/L vs. UD |
UD–19 μg/L |
Spontaneous abortion |
Water source, maternal age, educational level, history of prior spontaneous abortion |
7/9 |
Abbreviations: BMI, body mass index; BP, blood pressure; C-C, case–control study; CS, cross-sectional study; HDSS, health and demographic surveillance system; NA, not applicable; NOS, Newcastle–Ottawa Scale; PCO, prospective cohort study; RCO, retrospective cohort study; UD, undetected. aStudies examining low to moderate arsenic dose in the general population. bStudies examining high arsenic dose in the general population. cStudies applying biomarkers/individual-level data. dStudies applying group/ecological data. eStudies that did not control for potential confounders. |