Prenatal arsenic exposure, child marriage, and pregnancy weight gain: Associations with preterm birth in Bangladesh

Background: Preterm birth is a disease of multifactorial etiologies that has environmental, social, and maternal health components. In Bangladesh, environmental arsenic exposure, child marriage, and low maternal weight gain during pregnancy are highly prevalent. These factors are often studied individually in relation to preterm birth; although, they may have interactive effect. Objective: To evaluate the associations between prenatal arsenic exposure, child marriage, pregnancy weight gain, and preterm birth in a prospective birth cohort in Bangladesh. Methods: During 2008–2011, we recruited 1,613 pregnant women aged ≥18 years at ≤16 weeks of gestation and followed them throughout pregnancy. We measured arsenic in drinking water (n=1,184) collected at enrollment and in maternal toenails (n=1,115) collected ≤1-month postpartum using inductively coupled plasma mass spectrometry.…