Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes
Background: Lithium, used for treating bipolar disease, crosses freely the placenta and is classified as teratogenic. It is unclear to what extent environmental lithium exposure may affect fetal growth and development. Objectives: To elucidate potential effects of lithium exposure through drinking w...
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doaj-8dfff716033f4933bb7ee6ce4ed9332c2020-11-24T22:14:34ZengElsevierEnvironment International0160-41202015-04-01774854Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean AndesFlorencia Harari0Margareta Langeén1Esperanza Casimiro2Matteo Bottai3Brita Palm4Helena Nordqvist5Marie Vahter6Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, SwedenUnit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, SwedenSupervisor Intermedio de Atención Primaria de la Salud, Área Operativa XXIX, Hospital Dr. Nicolás Cayetano Pagano, San Antonio de los Cobres, 4411 Salta, ArgentinaUnit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, SwedenUnit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, SwedenUnit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, SwedenUnit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden; Corresponding author.Background: Lithium, used for treating bipolar disease, crosses freely the placenta and is classified as teratogenic. It is unclear to what extent environmental lithium exposure may affect fetal growth and development. Objectives: To elucidate potential effects of lithium exposure through drinking water during pregnancy on fetal size. Methods: We developed a prospective population-based mother–child cohort (N = 194) in an area with highly varying drinking water lithium concentrations (5-1600 μg/L) in northern Argentinean Andes. Blood and urinary lithium concentrations (sampled repeatedly during pregnancy) were measured using inductively coupled plasma mass spectrometry. We measured fetal size by ultrasound in second and third trimesters, and weight, length and head circumference at birth. Multivariable models were used to examine associations between lithium exposure (continuous and in tertiles) and fetal size measures. Results: Lithium in maternal blood (median 25; range 1.9–145 μg/L) and urine (1645; 105–4600 μg/L) was inversely associated (apparently linearly) with all fetal measures (body, head and femur) in the second trimester, and with birth length (β −0.53 cm per 25 μg/L increase in blood lithium, 95%CI −1.0; −0.052). An increase of 100 μg/L in blood was associated with 2 cm shorter newborns (about one standard deviation). Conclusions: Lithium exposure through drinking water was associated with impaired fetal size and this seemed to be initiated in early gestation. Further studies are warranted to confirm causality and to understand the mechanisms. If confirmed, these findings have public health relevance and emphasize the need for more data on lithium concentrations in drinking water, including bottled water. Keywords: Birth weight, Fetal size, Early-life exposure, Lithium, Water pollutantshttp://www.sciencedirect.com/science/article/pii/S0160412015000227 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Florencia Harari Margareta Langeén Esperanza Casimiro Matteo Bottai Brita Palm Helena Nordqvist Marie Vahter |
spellingShingle |
Florencia Harari Margareta Langeén Esperanza Casimiro Matteo Bottai Brita Palm Helena Nordqvist Marie Vahter Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes Environment International |
author_facet |
Florencia Harari Margareta Langeén Esperanza Casimiro Matteo Bottai Brita Palm Helena Nordqvist Marie Vahter |
author_sort |
Florencia Harari |
title |
Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes |
title_short |
Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes |
title_full |
Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes |
title_fullStr |
Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes |
title_full_unstemmed |
Environmental exposure to lithium during pregnancy and fetal size: A longitudinal study in the Argentinean Andes |
title_sort |
environmental exposure to lithium during pregnancy and fetal size: a longitudinal study in the argentinean andes |
publisher |
Elsevier |
series |
Environment International |
issn |
0160-4120 |
publishDate |
2015-04-01 |
description |
Background: Lithium, used for treating bipolar disease, crosses freely the placenta and is classified as teratogenic. It is unclear to what extent environmental lithium exposure may affect fetal growth and development. Objectives: To elucidate potential effects of lithium exposure through drinking water during pregnancy on fetal size. Methods: We developed a prospective population-based mother–child cohort (N = 194) in an area with highly varying drinking water lithium concentrations (5-1600 μg/L) in northern Argentinean Andes. Blood and urinary lithium concentrations (sampled repeatedly during pregnancy) were measured using inductively coupled plasma mass spectrometry. We measured fetal size by ultrasound in second and third trimesters, and weight, length and head circumference at birth. Multivariable models were used to examine associations between lithium exposure (continuous and in tertiles) and fetal size measures. Results: Lithium in maternal blood (median 25; range 1.9–145 μg/L) and urine (1645; 105–4600 μg/L) was inversely associated (apparently linearly) with all fetal measures (body, head and femur) in the second trimester, and with birth length (β −0.53 cm per 25 μg/L increase in blood lithium, 95%CI −1.0; −0.052). An increase of 100 μg/L in blood was associated with 2 cm shorter newborns (about one standard deviation). Conclusions: Lithium exposure through drinking water was associated with impaired fetal size and this seemed to be initiated in early gestation. Further studies are warranted to confirm causality and to understand the mechanisms. If confirmed, these findings have public health relevance and emphasize the need for more data on lithium concentrations in drinking water, including bottled water. Keywords: Birth weight, Fetal size, Early-life exposure, Lithium, Water pollutants |
url |
http://www.sciencedirect.com/science/article/pii/S0160412015000227 |
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