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Environ Health. 2016 Nov 8;15(1):106.

Maternal arsenic exposure and gestational diabetes and glucose intolerance in the New Hampshire birth cohort study.

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Division of Environmental Health, Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, MC 9237, Los Angeles, CA, 90089, USA.
Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Department of Population Health, New York University School of Medicine, New York, NY, USA.
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.



Gestational diabetes mellitus (GDM) is a major pregnancy complication with detrimental effects for both mothers and their children. Accumulating evidence has suggested a potential role for arsenic (As) exposure in the development of GDM, but current studies have not assessed As exposure from water, urine or toenail samples.


We investigated the association between As exposure and risk of glucose intolerance and GDM among 1151 women enrolled in the New Hampshire Birth Cohort Study. Arsenic was measured in home well water and via biomarkers (i.e., maternal urine collected ~24-28 weeks gestation and toenail clippings collected 2 weeks postpartum).


A total of 105 (9.1 %) of women were diagnosed with glucose intolerance and 14 (1.2 %) of women were diagnosed with GDM. A total of 10.3 % of women had water As levels above 10 μg/L, with a mean As level of 4.2. Each 5 μg/L increase in As concentration in home well water was associated with a ~10 % increased odds of GDM (OR: 1.1, 95 % CI 1.0, 1.2). A positive and statistically significant association also was observed between toenail As and GDM (OR: 4.5, 95 % CI 1.2, 16.6), but not urinary arsenic (OR: 0.8, 95 % CI 0.3, 2.4). In a stratified analysis, the association between water As and GDM and glucose intolerance was largely limited to obese women (OR: 1.7, 95 % CI 1.0, 2.8).


Our findings support the role of As exposure via water from private wells in the incidence of GDM and that this association may be modified by body composition.


Arsenic; Gestational diabetes; Glucose intolerance; New Hampshire; Pregnancy cohort

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