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Is living in a region with high groundwater arsenic contamination associated with adverse reproductive health outcomes? An analysis using nationally representative data from India

Jessie Pinchoff, Population Council
Brent Monseur, Stanford University
Sapna Desai, Population Council
Katelyn Koons, Jefferson School of Medicine
Ruben Alvero, Stanford University
Michelle Hindin, The Population Council

Exposure to groundwater arsenic via drinking water is common in certain geographies, and causes a range of negative health effects, potentially including adverse reproductive health outcomes. We conducted an ecological analysis of rates of stillbirth, recurrent pregnancy loss (RPL), and infertility in relation to groundwater arsenic in India. A gridded, modeled dataset of the probability of groundwater arsenic exceeding 10 µg/L (World Health Organization drinking water limit) was spatially integrated with the India District Level Health Survey (DLHS-3) wave 3 conducted in 2007-08 (n = 643,944 women of reproductive age; 599 districts). Maps were generated for each outcome. To adjust for significant spatial autocorrelation, spatial error models were fit for each outcome. As the probability of groundwater arsenic levels exceeding 10 µg/L increased, there was a significant 3.8 percentage point (pp) increase in stillbirths (ß=0.038; 95% confidence interval 0.017, 0.059), 3.6pp in RPL (ß=0.036; 95% CI 0.20, 0.053), and 3.7 pp increase in infertility (ß=0.037, 95% CI 0.001, 0.066) at the district level. All models adjusted for urban/rural setting and demographic characteristics. Living in districts with high probability of groundwater arsenic contamination was significantly associated with adverse reproductive health outcomes including stillbirth, RPL, and infertility.

Keywords: Environmental studies, Sexual and Reproductive Health and Rights, Geographic Information Systems (GIS)

See extended abstract.

  Presented in Session 204. Multidimensional Links: Environmental Conditions, Fertility, and Reproductive and Maternal Health