Salinity in drinking water and the risk of (pre)eclampsia and gestational hypertension in coastal Bangladesh: a case-control study.

TitleSalinity in drinking water and the risk of (pre)eclampsia and gestational hypertension in coastal Bangladesh: a case-control study.
Publication TypeJournal Article
Year of Publication2014
AuthorsKhan A E, Scheelbeek PFranka Den, Shilpi ABegum, Chan Q, Mojumder S K, Rahman A, Haines A, Vineis P
JournalPLoS One
Volume9
Issue9
Paginatione108715
Date Published09/2014
ISSN1932-6203
KeywordsAdolescent, Adult, Asian Continental Ancestry Group, Bangladesh, Blood Pressure, Case-Control Studies, Drinking Water, Female, Gestational Age, Humans, Hypertension, Pregnancy-Induced, Middle Aged, Odds Ratio, Pre-Eclampsia, Pregnancy, Risk Factors, Sodium, Young Adult
Abstract

BACKGROUND: Hypertensive disorders in pregnancy are among the leading causes of maternal and perinatal death in low-income countries, but the aetiology remains unclear. We investigated the relationship between salinity in drinking water and the risk of (pre)eclampsia and gestational hypertension in a coastal community.

METHODS: A population-based case-control study was conducted in Dacope, Bangladesh among 202 pregnant women with (pre)eclampsia or gestational hypertension, enrolled from the community served by the Upazilla Health Complex, Dacope and 1,006 matched controls from the same area. Epidemiological and clinical data were obtained from all participants. Urinary sodium and sodium levels in drinking water were measured. Logistic regression was used to calculate odds ratios, and 95% confidence intervals.

FINDINGS: Drinking water sources had exceptionally high sodium levels (mean 516.6 mg/L, S.D 524.2). Women consuming tube-well (groundwater) were at a higher disease risk than rainwater users (p<0.001). Adjusted risks for (pre)eclampsia and gestational hypertension considered together increased in a dose-response manner for increasing sodium concentrations (300.01-600 mg/L, 600.1-900 mg/L, >900.01 mg/L, compared to <300 mg/L) in drinking water (ORs 3.30 [95% CI 2.00-5.51], 4.40 [2.70-7.25] and 5.48 [3.30-9.11] (p-trend<0.001). Significant associations were seen for both (pre)eclampsia and gestational hypertension separately.

INTERPRETATION: Salinity in drinking water is associated with increased risk of (pre)eclampsia and gestational hypertension in this population. Given that coastal populations in countries such as Bangladesh are confronted with high salinity exposure, which is predicted to further increase as a result of sea level rise and other environmental influences, it is imperative to develop and evaluate affordable approaches to providing water with low salt content.

DOI10.1371/journal.pone.0108715
Alternate JournalPLoS ONE
PubMed ID25268785
PubMed Central IDPMC4182542