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. 2013 Sep 16;8(9):e74119.
doi: 10.1371/journal.pone.0074119. eCollection 2013.

Elevated manganese concentrations in drinking water may be beneficial for fetal survival

Syed Moshfiqur Rahman  1 , Agneta Akesson, Maria Kippler, Margaretha Grandér, Jena Derakhshani Hamadani, Peter Kim Streatfield, Lars-Åke Persson, Shams El Arifeen, Marie Vahter
Affiliations

Elevated manganese concentrations in drinking water may be beneficial for fetal survival

Syed Moshfiqur Rahman et al. PLoS One. .

Abstract

Background: Elevated exposure to the essential element manganese (Mn) can be toxic. Manganese concentrations in ground water vary considerably, and reported associations between Mn and early-life mortality and impaired development have raised concern. We assessed the effects of drinking water Mn exposure during pregnancy upon fetal and infant survival.

Methods: In this population-based cohort study, we identified the outcomes of pregnancies registered between February 2002 and April 2003 in Matlab, Bangladesh. Using inductively coupled plasma mass spectrometry, we measured the concentrations of Mn and other elements in the pregnant women's drinking water.

Results: A total of 1,875 women were included in the analysis of spontaneous abortions (n=158) and 1,887 women in the perinatal mortality analysis (n=70). Water Mn ranged from 3.0-6,550 µg/L (median=217 µg/L). The adjusted odds ratio (OR) for spontaneous abortion was 0.65 (95% CI 0.43-0.99) in the highest water Mn tertile (median=1,292 µg/L) as compared to the lowest tertile (median=56 µg/L). The corresponding OR for perinatal mortality was 0.69 (95% CI 0.28-1.71), which increased to 0.78 (95% CI 0.29-2.08) after adjustment for BMI and place of delivery (home/health facility; n=1,648).

Conclusions: Elevated water Mn concentrations during pregnancy appear protective for the fetus, particularly in undernourished women. This effect may be due to the element's role in antioxidant defense.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart depicting selection of pregnancy cohort (February 2002 to April 2003).
See this image and copyright information in PMC

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