{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:28:35Z","timestamp":1788348515041,"version":"build-2803163510"},"reference-count":81,"publisher":"American Chemical Society (ACS)","issue":"5","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":1067,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exposure to arsenic is one of the major global health problems, affecting &amp;gt; 300 million people worldwide, but arsenic\u2019s effects on human reproduction are uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis to examine the association between arsenic and adverse pregnancy outcomes\/infant mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed and Ovid MEDLINE (from 1946 through July 2013) and EMBASE (from 1988 through July 2013) databases and the reference lists of reviews and relevant articles. Studies satisfying our a priori eligibility criteria were evaluated independently by two authors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our systematic search yielded 888 articles; of these, 23 were included in the systematic review. Sixteen provided sufficient data for our quantitative analysis. Arsenic in groundwater (\u2265 50 \u03bcg\/L) was associated with increased risk of spontaneous abortion (6 studies: OR = 1.98; 95% CI: 1.27, 3.10), stillbirth (9 studies: OR = 1.77; 95% CI: 1.32, 2.36), moderate risk of neonatal mortality (5 studies: OR = 1.51; 95% CI: 1.28, 1.78), and infant mortality (7 studies: OR = 1.35; 95% CI: 1.12, 1.62). Exposure to environmental arsenic was associated with a significant reduction in birth weight (4 studies: \u03b2 = \u201353.2 g; 95% CI: \u201394.9, \u201311.4). There was paucity of evidence for low-to-moderate arsenic dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Arsenic is associated with adverse pregnancy outcomes and infant mortality. The interpretation of the causal association is hampered by methodological challenges and limited number of studies on dose response. Exposure to arsenic continues to be a major global health issue, and we therefore advocate for high-quality prospective studies that include individual-level data to quantify the impact of arsenic on adverse pregnancy outcomes\/infant mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Citation<\/jats:title>\n                    <jats:p>Quansah R, Armah FA, Essumang DK, Luginaah I, Clarke E, Marfoh K, Cobbina SJ, Nketiah-Amponsah E, Namujju PB, Obiri S, Dzodzomenyo M. 2015. Association of arsenic with adverse pregnancy outcomes\/infant mortality: a systematic review and meta-analysis. Environ Health Perspect 123:412\u2013421;\u2002http:\/\/dx.doi.org\/10.1289\/ehp.1307894<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1289\/ehp.1307894","type":"journal-article","created":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T12:11:56Z","timestamp":1422360716000},"page":"412-421","source":"Crossref","is-referenced-by-count":330,"title":["Association of Arsenic with Adverse Pregnancy Outcomes\/Infant Mortality: A Systematic Review and Meta-Analysis"],"prefix":"10.1021","volume":"123","author":[{"given":"Reginald","family":"Quansah","sequence":"first","affiliation":[{"name":"Centre for Environmental and Respiratory Health Research, Faculty of Medicine, University Of Oulu, Finland"},{"name":"Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Ato","family":"Armah","sequence":"additional","affiliation":[{"name":"Environment, Health and Hazards Lab, Department of Geography, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Kofi","family":"Essumang","sequence":"additional","affiliation":[{"name":"Environmental Health Group, Department of Chemistry, University of Cape Coast, Cape Coast, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Luginaah","sequence":"additional","affiliation":[{"name":"Department of Geography, Western University Canada, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana"},{"name":"Ghana Health Service, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kissinger","family":"Marfoh","sequence":"additional","affiliation":[{"name":"Public Health Unit (Biostatistics), Korle-bu Teaching Hospital, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Jerry","family":"Cobbina","sequence":"additional","affiliation":[{"name":"School of the Environment, Jiangsu University, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Nketiah-Amponsah","sequence":"additional","affiliation":[{"name":"Department of Economics, University of Ghana, Legon, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Proscovia Bazanya","family":"Namujju","sequence":"additional","affiliation":[{"name":"Department of Child, Adolescent and Adult Health, National Institute for Health and Welfare, Oulu, Finland"},{"name":"School of Health Sciences, University of Tampere, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Obiri","sequence":"additional","affiliation":[{"name":"Council for Scientific and Industrial Research, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mawuli","family":"Dzodzomenyo","sequence":"additional","affiliation":[{"name":"Department of Biological, Environmental & Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2015,1,27]]},"reference":[{"key":"2026080606023272300_micit1","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1289\/ehp.1103988","article-title":"Arsenic exposure and hypertension: a systematic review.","volume":"120","author":"Abhyankar","year":"2012","journal-title":"Environ Health 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