Objective:To systematically evaluate the association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.Methods:Web of Science, PubMed, CNKI database, the VIP Chinese Journal Service Platform and Wanfang Data Knowledge Service Platform were searched for studies on the association between maternal arsenic exposure and spontaneous abortion, stillbirth, and preterm birth before December 2023. Meta-analysis of binary variables was conducted using Stata MP 17.0 software, with OR value(95% CI) as the effect analysis indicator, and subgroup analysis was used to explore the sources of heterogeneity. Results:A total of 21 articles were included ( n = 5 150 286). The meta-analysis results showed that maternal arsenic exposure was positively correlated with spontaneous abortion, stillbirth, and preterm birth, with pooled OR values (95% CI) of 1.48 (1.28 - 1.70), 1.98 (1.60 - 2.45), and 1.05 (1.02 - 1.07), respectively. Subgroup analyses showed that arsenic exposure was positively correlated with the risk of preterm birth in both prospective cohort studies ( OR = 1.18, 95% CI: 1.09 - 1.27) and cross-sectional studies ( OR = 1.10, 95% CI: 1.06 - 1.15). Internal exposure to arsenic ( OR = 1.15, 95% CI: 1.04 - 1.28) presented a more pronounced risk of preterm birth compared to external exposure ( OR = 1.05, 95% CI: 1.01 - 1.10). Moreover, the impact was more substantial in developing countries ( OR = 1.17, 95% CI: 1.06 - 1.29), while it was not statistically significant in developed countries [1.04 (1.00 - 1.09), P > 0.05]. Conclusion:There is a positive association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.

Objective:To systematically evaluate the association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.Methods:Web of Science, PubMed, CNKI database, the VIP Chinese Journal Service Platform and Wanfang Data Knowledge Service Platform were searched for studies on the association between maternal arsenic exposure and spontaneous abortion, stillbirth, and preterm birth before December 2023. Meta-analysis of binary variables was conducted using Stata MP 17.0 software, with OR value(95% CI) as the effect analysis indicator, and subgroup analysis was used to explore the sources of heterogeneity. Results:A total of 21 articles were included ( n = 5 150 286). The meta-analysis results showed that maternal arsenic exposure was positively correlated with spontaneous abortion, stillbirth, and preterm birth, with pooled OR values (95% CI) of 1.48 (1.28 - 1.70), 1.98 (1.60 - 2.45), and 1.05 (1.02 - 1.07), respectively. Subgroup analyses showed that arsenic exposure was positively correlated with the risk of preterm birth in both prospective cohort studies ( OR = 1.18, 95% CI: 1.09 - 1.27) and cross-sectional studies ( OR = 1.10, 95% CI: 1.06 - 1.15). Internal exposure to arsenic ( OR = 1.15, 95% CI: 1.04 - 1.28) presented a more pronounced risk of preterm birth compared to external exposure ( OR = 1.05, 95% CI: 1.01 - 1.10). Moreover, the impact was more substantial in developing countries ( OR = 1.17, 95% CI: 1.06 - 1.29), while it was not statistically significant in developed countries [1.04 (1.00 - 1.09), P > 0.05]. Conclusion:There is a positive association between maternal arsenic exposure and spontaneous abortion, stillbirth and preterm birth.