Association between Arsenic Exposure in Drinking Water and Stillbirth:A Meta-Analysis

There is controversial evidence from cross-sectional, ecological, cohort and case-control studies that arsenic exposure in drinking water is a risk factor for stillbirth. The objectives of this meta-analysis were to evaluate the association of stillbirth and arsenic exposure in drinking water and to improve the precision of estimates. A database search was conducted to identify relevant studies. The odds ratios (ORs) extracted from each study were pooled by using Mantel-Haenszel fixed effect model, while subgroup analysis was conducted by using random effect model. Heterogeneity of ORs in the included studies was analysed using I² statistics. Publication bias was tested by Begg’s test. Eight studies involving 51,476 participants met the inclusion criteria. The pooled ORs of studies was 1.54 (95% CI: 1.32-1.79) with a small heterogeneity (I^² = 25%, P =0.23) across studies and no publication bias was evident. This meta-analysis provided evidence that chronic arsenic exposure above 50 μg.L^-1 in drinking water is a significant risk factor for stillbirth.