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Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh
BACKGROUND: Epidemiological evidence suggests that arsenic (As) exposure during pregnancy may reduce infant birth weight. One significant source of As exposure is diet; thus, As may indirectly affect infant growth by mediating the effect of maternal diet on birth weight (BW). This study evaluated th...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364468/ https://www.ncbi.nlm.nih.gov/pubmed/30728020 http://dx.doi.org/10.1186/s12940-019-0450-1 |
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author | Lin, Pi-I D. Bromage, Sabri Mostofa, Md. Golam Rahman, Mohammad Allen, Joseph Oken, Emily Kile, Molly L. Christiani, David C. |
author_facet | Lin, Pi-I D. Bromage, Sabri Mostofa, Md. Golam Rahman, Mohammad Allen, Joseph Oken, Emily Kile, Molly L. Christiani, David C. |
author_sort | Lin, Pi-I D. |
collection | PubMed |
description | BACKGROUND: Epidemiological evidence suggests that arsenic (As) exposure during pregnancy may reduce infant birth weight. One significant source of As exposure is diet; thus, As may indirectly affect infant growth by mediating the effect of maternal diet on birth weight (BW). This study evaluated the potential mediating effect of As in the relationship between maternal diet and BW, gestational age (GA), and gestational weight gain (GWG). METHOD: The study used a prospective birth cohort in Bangladesh that captured the dietary habits of 1057 pregnant women through validated semi-quantitative food frequency questionnaires. We applied a causal mediation model with counterfactual approach and performed analyses with and without adjustment for total energy intake. Other potential confounders captured by self-report questionnaire were exposure to secondhand tobacco smoke, betel nut chewing, maternal age, education level, household income level, physical activity level during pregnancy, and daily hours spent cooking over open fire. RESULT: No association was found between maternal toenail As and BW. Higher absolute and energy-adjusted protein, fat and fiber intakes were associated with higher toenail As and lower GA and GWG, while higher absolute and energy-adjusted carbohydrate intake was associated with lower toenail As and greater GA and GWG. Mediation analysis showed significant natural indirect effects by toenail As in the relationships between absolute fat, carbohydrate and fiber intake with GA. Specifically, 3% (95% CI: 1–6%) of the association between carbohydrate intake and GA was mediated by change in toenail As, 6% (95% CI: 1–9%) for absolute fat intake and 10% (95% CI: 4–13%) for absolute fiber intake. After adjusting for total energy, no significant mediating effect was observed, suggesting the mediating effect might be due to measurement error or that absolute amount of As exposure rather than the amount in relationship to total energy intake was a more important factor to consider when understanding the negative implication of As on fetal growth. CONCLUSION: The mediating effect of As in the relationship between maternal diet and birth outcome was small and might be due to measurement error. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12940-019-0450-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6364468 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63644682019-02-15 Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh Lin, Pi-I D. Bromage, Sabri Mostofa, Md. Golam Rahman, Mohammad Allen, Joseph Oken, Emily Kile, Molly L. Christiani, David C. Environ Health Research BACKGROUND: Epidemiological evidence suggests that arsenic (As) exposure during pregnancy may reduce infant birth weight. One significant source of As exposure is diet; thus, As may indirectly affect infant growth by mediating the effect of maternal diet on birth weight (BW). This study evaluated the potential mediating effect of As in the relationship between maternal diet and BW, gestational age (GA), and gestational weight gain (GWG). METHOD: The study used a prospective birth cohort in Bangladesh that captured the dietary habits of 1057 pregnant women through validated semi-quantitative food frequency questionnaires. We applied a causal mediation model with counterfactual approach and performed analyses with and without adjustment for total energy intake. Other potential confounders captured by self-report questionnaire were exposure to secondhand tobacco smoke, betel nut chewing, maternal age, education level, household income level, physical activity level during pregnancy, and daily hours spent cooking over open fire. RESULT: No association was found between maternal toenail As and BW. Higher absolute and energy-adjusted protein, fat and fiber intakes were associated with higher toenail As and lower GA and GWG, while higher absolute and energy-adjusted carbohydrate intake was associated with lower toenail As and greater GA and GWG. Mediation analysis showed significant natural indirect effects by toenail As in the relationships between absolute fat, carbohydrate and fiber intake with GA. Specifically, 3% (95% CI: 1–6%) of the association between carbohydrate intake and GA was mediated by change in toenail As, 6% (95% CI: 1–9%) for absolute fat intake and 10% (95% CI: 4–13%) for absolute fiber intake. After adjusting for total energy, no significant mediating effect was observed, suggesting the mediating effect might be due to measurement error or that absolute amount of As exposure rather than the amount in relationship to total energy intake was a more important factor to consider when understanding the negative implication of As on fetal growth. CONCLUSION: The mediating effect of As in the relationship between maternal diet and birth outcome was small and might be due to measurement error. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12940-019-0450-1) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-06 /pmc/articles/PMC6364468/ /pubmed/30728020 http://dx.doi.org/10.1186/s12940-019-0450-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Lin, Pi-I D. Bromage, Sabri Mostofa, Md. Golam Rahman, Mohammad Allen, Joseph Oken, Emily Kile, Molly L. Christiani, David C. Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title | Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title_full | Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title_fullStr | Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title_full_unstemmed | Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title_short | Mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in Bangladesh |
title_sort | mediating role of arsenic in the relationship between diet and pregnancy outcomes: prospective birth cohort in bangladesh |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364468/ https://www.ncbi.nlm.nih.gov/pubmed/30728020 http://dx.doi.org/10.1186/s12940-019-0450-1 |
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