{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:11:51Z","timestamp":1778616711662,"version":"3.51.4"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980022001318_as1\"><jats:title>Objectives:<\/jats:title><jats:p>To explore associations between maternal pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980022001318_as2\"><jats:title>Design:<\/jats:title><jats:p>This is a population-based, case\u2013control study using maternal responses to a dietary assessment and published arsenic concentration estimates in food items to calculate average daily total and inorganic arsenic exposure during the year before pregnancy. Assigning tertiles of total and inorganic arsenic exposure, logistic regression analysis was used to estimate OR for middle and high tertiles, compared to the low tertile.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980022001318_as3\"><jats:title>Setting:<\/jats:title><jats:p>US National Birth Defects Prevention Study, 1997\u20132011.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980022001318_as4\"><jats:title>Participants:<\/jats:title><jats:p>Mothers of 10 446 children without birth defects and 14 408 children diagnosed with a non-cardiac birth defect.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980022001318_as5\"><jats:title>Results:<\/jats:title><jats:p>Maternal exposure to total dietary arsenic in the middle and high tertiles was associated with a threefold increase in cloacal exstrophy, with weak positive associations (1\u00b72\u20131\u00b75) observed either in both tertiles (intercalary limb deficiency) or the high tertile only (encephalocele, glaucoma\/anterior chamber defects and bladder exstrophy). Maternal exposure to inorganic arsenic showed mostly weak, positive associations in both tertiles (colonic atresia\/stenosis, oesophageal atresia, bilateral renal agenesis\/hypoplasia, hypospadias, cloacal exstrophy and gastroschisis), or the high (glaucoma\/anterior chamber defects, choanal atresia and intestinal atresia stenosis) or middle (encephalocele, intercalary limb deficiency and transverse limb deficiency) tertiles only. The remaining associations estimated were near the null or inverse.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980022001318_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>This exploration of arsenic in diet and non-cardiac birth defects produced several positive, but mostly weak associations. Limitations in exposure assessment may have resulted in exposure misclassification. Continued research with improved exposure assessment is recommended to identify if these associations are true signals or chance findings.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980022001318","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T08:18:29Z","timestamp":1653639509000},"page":"620-632","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Pre-pregnancy exposure to arsenic in diet and non-cardiac birth defects"],"prefix":"10.1017","volume":"26","author":[{"given":"Jonathan","family":"Suhl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin M","family":"Conway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Rhoads","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter H","family":"Langlois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia L","family":"Feldkamp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian M","family":"Michalski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob J","family":"Oleson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alpa","family":"Sidhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijaya","family":"Kancherla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Obrycki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maitreyi","family":"Mazumdar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A","family":"Romitti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the National Birth Defects Prevention Study","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"S1368980022001318_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2018.07.012"},{"key":"S1368980022001318_ref38","volume-title":"SAS 9.4","year":"2013"},{"key":"S1368980022001318_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0773.1984.tb01936.x"},{"key":"S1368980022001318_ref39","first-page":"3597","article-title":"Dietary exposure to inorganic arsenic in the European population","volume":"12","year":"2014","journal-title":"EFSA J"},{"key":"S1368980022001318_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2012.10.015"},{"key":"S1368980022001318_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s40550-014-0003-x"},{"key":"S1368980022001318_ref28","volume-title":"Total Diet Study Statistics on Element Results","year":"2007"},{"key":"S1368980022001318_ref8","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1634"},{"key":"S1368980022001318_ref15","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.ijheh.2014.05.002","article-title":"Arsenic in drinking water and congenital heart anomalies in Hungary","volume":"217","author":"Rudnai","year":"2014","journal-title":"Int J Hyg Environ Health"},{"key":"S1368980022001318_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"S1368980022001318_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.08.028"},{"key":"S1368980022001318_ref40","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1307894"},{"key":"S1368980022001318_ref41","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp226"},{"key":"S1368980022001318_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(21)03057-1"},{"key":"S1368980022001318_ref27","volume-title":"Analytical Methods Used in the Total Diet Study","year":"2018"},{"key":"S1368980022001318_ref13","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1093\/ije\/17.3.589","article-title":"Chemical quality of maternal drinking water and congenital heart disease","volume":"17","author":"Zierler","year":"1988","journal-title":"Int J Epidemiol"},{"key":"S1368980022001318_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-6915(99)00073-3"},{"key":"S1368980022001318_ref1","volume-title":"Toxicological Profile for Arsenic","year":"2007"},{"key":"S1368980022001318_ref4","first-page":"6976","article-title":"National primary drinking water regulations; 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