The Bangladesh arsenic calamity and reproduction

Does arsenic contamination of drinking water result in foetal wastage, intrauterine growth retardation, neonatal deaths and impaired cognitive development, and to what extent can nutrition intervention reduce the risk?

Project Summary

While it is most likely that the presence of high arsenic concentrations in the tube wells in Bangladesh will cause severe morbidity (i.e. skin lesions, cancers, lung disease, diabetes), the risk for negative reproductive outcomes is not known. This project looks at the associations between arsenic exposure during pregnancy (urinary arsenic at gestational weeks 8, 14, 18 and 30) and pregnancy wastage (miscarriages, stillbirth), early neonatal death, and impaired psycho-motor development in infancy. Further, we will determine if efficient metabolism (methylation) of arsenic decreases arsenic-induced foetal toxicity and, lastly, if early supplementation of food and multiple micronutrient supplements (as compared to routine iron-folate) decrease arsenic-induced foetal toxicity. Benefiting from the research infrastructure provided by the health and demographic surveillance system in Matlab, this study is nested into an ongoing food and micronutrient supplementation trial in 3000 women. It provides a unique opportunity to get a final answer to the question of whether arsenic exposure in pregnancy results in foetal and/or infant deaths and if exposure damages the development of cognitive function in infancy. It will also provide information on the possible protective role of food and micronutrient supplements against arsenic toxicity. Such new knowledge would have direct relevance for the arsenic-related programmes in Bangladesh and globally.