Daily arsenic contamination associated with Gestational diabetes mellitus and neonatal outcome

Abstract

Association of chronic arsenic exposure with diabetes mellitus is fairly well established, but the association of arsenic toxicity with glucose intolerance in pregnancy and with neonatal outcome have yet not been studied adequately. The present study was undertaken to explore the association of chronic arsenic exposure with gestational diabetes mellitus (GDM) and neonatal outcome in a Bangladeshi population. Under an observational cross-sectional design a total of 263 pregnant women (age in yrs, M±SD, 21±3.7) residing in an arsenic affected area of Bangladesh, were subjected to a 2 sample OGTT at third trimester of gestation. Clinical and anthropometric measurements were done by standard techniques. Degree of chronic arsenic exposure was assessed by the level of As in the usable (drinking, cooking, washing and bathing) water at the respective households and total urinary arsenic level. GDM was diagnosed by WHO criteria and neonatal outcome was assessed using APGAR Score measured by a Specialist Obstetrician. Serum glucose was measured by Glucose Oxidase method and As level in water (WAs) was measured by ultraviolet/visible spectrophotometry. Out of the 263 pregnant women 73(28%) developed GDM. WAs was significantly higher in the GDM as compared to the Non-GDM group [WAs, ìg/l, median (range), 62(34-354) vs 3.6(1.02-99), p<0.001]. Apger Score of the neonates from GDM mothers was significantly lower compared to the neonates from Non-GDM mothers [APGER Score, M±SD, 4.7±0.8 vs 6.4±0.7, p<0.001]. On Pearson’s correlation analysis in GDM subjects, both fasting and postprandial serum glucose levels were found to have a significant positive correlation with WAs levels (r=0.429;p=<0.001) and water arsenic and also significant positive correlation with water arsenic (r=0.234; p<0.001). The APGER Score of the neonates were found to have a significant negative correlation (r=- 0.233; p=0.041) with WAs level. Chronic arsenic exposure is associated with worsening of glucose intolerance during pregnancy and it also affects neonatal outcome in an adverse way.