Environmental exposure to arsenic and cadmium during pregnancy and fetal size: A longitudinal study in rural Bangladesh

Prenatal exposures to arsenic (As) and cadmium (Cd) have been associated with decreased size at birth. We here studied associations of prenatal As and Cd exposures with multiple fetal size parameters measured by ultrasound in gestational week (GW) 14 and 30 in a population-based mother–child cohort in rural Bangladesh. We measured As (n = 1929) and Cd (n = 1616) in urine during pregnancy. In the longitudinal evaluation of combined exposure, urinary Cd (UCd) showed an inverted U-shaped association (turning-point 1.5 μg Cd/L) with all fetal size parameters, while UAs showed no significant association. Cross-sectional analyses indicated that associations with UCd were somewhat stronger in early gestation. Stratification indicated stronger associations between UCd and fetal size in girls than in boys, and in poorer than in richer families, while UAs was weakly associated with fetal size in boys. In conclusion, particularly Cd, but also As, appeared to influence fetal development in a sex-dependent manner.

► Elevated maternal Cd was inversely correlated with all fetal size parameters. ► Cd had a larger impact in girls vs. boys, and in families with low vs. high SES. ► As was weakly inversely correlated with head size and femur length. ► The inverse correlations with As were only apparent in boys, not in girls.