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Fahmida Tofail,¹ Marie Vahter,² Jena D. Hamadani,¹ Barbro Nermell,² Syed N. Huda,³ Mohammad Yunus,¹ Mahfuzar Rahman,^1,4 and Sally M. Grantham-McGregor⁵

¹Child Development Unit, Clinical Sciences Division and Public Health Sciences Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh; ²Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; ³Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh; ⁴Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA; ⁵Centre for International Health and Development Institute of Child Health, University College London, London, United Kingdom

Abstract
Background: Exposure to arsenic-contaminated drinking water during pregnancy is associated with low birth weight and fetal loss, and there is concern that the infants' development may be affected.

Objective: We assessed the effects of in utero arsenic exposure during pregnancy on infants' problem-solving ability and motor development.

Methods: We conducted a large population-based study of nutritional supplementation with 4,436 pregnant women in Matlab, Bangladesh, an area of high-arsenic–contaminated tube wells. We measured arsenic concentration in spot urine specimens at 8 and 30 weeks of pregnancy. We assessed a subsample of 1,799 infants, born to these mothers, at 7 months of age on two problem-solving tests (PSTs) , the motor scale of the Bayley Scales of Infant Development–II, and behavior ratings.

Result: Arsenic concentrations in maternal urine were high, with a median (interquartile range) of 81 µg/L (37–207 µg/L) at 8 weeks of gestation and of 84 µg/L (42–230 µg/L) at 30 weeks. Arsenic exposure was related to many poor socioeconomic conditions that also correlated with child development measures. Multiple regressions of children's motor and PST scores and behavior ratings, controlling for socioeconomic background variables, age, and sex, showed no significant effect of urinary arsenic concentration on any developmental outcome.

Conclusion: We detected no significant effect of arsenic exposure during pregnancy on infant development. However, it is possible that other effects are as yet unmeasured or that effects will become apparent at a later age.

Key words: Bangladesh cognitive function, infants, motor development, problem-solving tests, urinary arsenic. Environ Health Perspect 117:288–293 (2009) . doi:10.1289/ehp.11670 available via http://dx.doi.org/ [Online 24 October 2008]

Address correspondence to S. Grantham-McGregor, CIHD, Institute of Child Health, 30 Guilford St., London WC1N 1EH UK. Telephone: 44-0-20-7242-9789. Fax: 44-0-20-7831-0488. E-mail: sallymcgregor@yahoo.com

We thank P. Willatts for assistance with cognitive tests, the testers, supervisors, and participants.

The work was supported by the International Centre for Diarrheal Disease Research, Bangladesh ; United Nations Children's Fund ; Swedish International Development Cooperation ; U.K. Medical Research Council ; Swedish Research Council ; U.K. Department for International Development ; Global Health Research Fund, Japan ; Child Health and Nutrition Research Initiative ; and Uppsala University.

The authors declare they have no competing financial interests.

Received 7 May 2008 ; accepted 24 October 2008.