Background
There is increasing evidence of the role of arsenic in the etiology of adverse human reproductive outcomes. Since drinking water can be a major source of arsenic to pregnant women, the effect of arsenic exposure through drinking water on human birth may be revealed by a geospatial association between arsenic concentration in groundwater and birth problems, particularly in a region where private wells substantially account for water supply, like New Hampshire, US.
Methods
We calculated town-level rates of preterm birth and term low birth weight (term LBW) for New Hampshire, using data for 1997-2009 and stratified by maternal age. We smoothed the rates using a locally-weighted averaging method to increase the statistical stability. The town-level groundwater arsenic values are from three GIS data layers generated by the US Geological Survey: probability of local groundwater arsenic concentration > 1 μg/L, probability > 5 μg/L, and probability > 10 μg/L. We calculated Pearson's correlation coefficients (r) between the reproductive outcomes (preterm birth and term LBW) and the arsenic values, at both state and county levels.
Results
For preterm birth, younger mothers (maternal age < 20) have a statewide r = 0.70 between the rates smoothed with a threshold = 2,000 births and the town mean arsenic level based on the data of probability > 10 μg/L; For older mothers, r = 0.19 when the smoothing threshold = 3,500; A majority of county level r values are positive based on the arsenic data of probability > 10 μg/L. For term LBW, younger mothers (maternal age < 25) have a statewide r = 0.44 between the rates smoothed with a threshold = 3,500 and town minimum arsenic level based on the data of probability > 1 μg/L; For older mothers, r = 0.14 when the rates are smoothed with a threshold = 1,000 births and also adjusted by town median household income in 1999, and the arsenic values are the town minimum based on probability > 10 μg/L. At the county level, for younger mothers positive r values prevail, but for older mothers it is a mix. For both birth problems, the several most populous counties - with 60-80% of the state's population and clustering at the southwest corner of the state – are largely consistent in having a positive r across different smoothing thresholds.
Conclusion
We found evident spatial associations between the two adverse human reproductive outcomes and groundwater arsenic in New Hampshire, US. However, the degree of associations and their sensitivity to different representations of arsenic level are variable. Generally, preterm birth has a stronger spatial association with groundwater arsenic than term LBW, suggesting an inconsistency in the impact of arsenic on the two reproductive outcomes. For both outcomes, younger maternal age has stronger spatial associations with groundwater arsenic.