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Impact of Gestational Arsenic Exposure and Maternal Folate Status on Child Health: A Phenome Approach


Arsenic is a known toxic and pervasive environmental exposure, associated with adverse health outcomes, even at low levels. Folic acid facilitates the excretion of arsenic from the body and may even reduce arsenic related health effects. The rapidly developing fetus is particularly vulnerable to environmental insults during pregnancy, and exposure to environmental risk factors, such as arsenic, may increase the risk of non-optimal neurodevelopment and growth. Additionally, prior studies have not determined if environmental exposures increase the risk of multi-morbidity in children. We investigated the mitigating impact of maternal folate status on the adverse effects of gestational arsenic exposure on phenotypic profiles of child neurodevelopmental and anthropometric health outcomes. We used data from mother-child pairs (age 3 years) who participated in the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective cohort study. First, we used latent profile analysis to identify two sets of phenotypic profiles: one for 6 neurodevelopmental outcomes and another for 6 anthropometric outcomes. We identified maternal, reproductive, and child level characteristics associated with phenotypic profile classification. Using concentrations of arsenic quantified in 1st trimester urine samples, we estimated covariate adjusted associations of urinary arsenic exposure with odds of phenotypic profile membership. Finally, we evaluated how 1st and 3rd trimester plasma folate concentrations, and 1st trimester folic acid intake modified the relation between 1st trimester urinary arsenic concentrations and phenotypic profiles. We identified three profiles of neurodevelopmental outcomes (Non-optimal, Typical, and Optimal) and three anthropometric profiles (Low, Average, and Excess Adiposity). These were associated with maternal, demographic, and child level characteristics. We observed limited evidence that gestational arsenic exposure was associated with phenotypic profiles. Maternal folate status did not substantially alter the pattern of results between gestational arsenic exposure and phenotypic profiles. Low levels of urinary arsenic concentrations were not associated with patterns of atypical child neurodevelopment or increased adiposity, nor did maternal folate status modify these associations. Future work should consider examining these outcomes in more highly exposed populations, with larger ranges of folate status.
Thesis (Ph. D.)--Brown University, 2022


Patti, Marisa Ann, "Impact of Gestational Arsenic Exposure and Maternal Folate Status on Child Health: A Phenome Approach" (2022). Epidemiology Theses and Dissertations. Brown Digital Repository. Brown University Library.