Heavy Metals and Reproductive Health - Reproductive Health Problems among Women of Childbearing Age in Alaverdi (Lori marz) and Artik (Shirak marz) Cities: a Cross-sectional Survey

Abstract

Introduction. Heavy metals and sulfur dioxide can adversely influence reproductive health of women. The main aim of the study was to find out the prevalence of reproductive health problems, particularly infertility, miscarriages, and abnormal births and check if there was an association between living near the polymetalic smelter (as a proxy measure for being exposed to heavy metals and sulfur dioxide) after controlling for other reproductive health risk factors. Methods. A cross-sectional study was conducted with 370 participants (ever married women of reproductive age) from smelter town Alaverdi and 370 participants from the comparison town Artik. The instrument of the study was a self-administered questionnaire. The main outcome variables of interest were infertility, miscarriages, induced abortions due to medical indications, stillbirths, perinatal mortality, and birth defects. The main independent variable of the study was living in Alaverdi or Artik (proxy measure of being exposed to heavy metals and sulfur dioxide). The study used multi stage cluster sampling strategy. Results. The odds of having stillbirth was 2.38 times higher (p= 0.033), the odds of having an induced abortion due to medical indications (health/life threatening pregnancy, congenital defects, dead fetus) was 2.67 times higher (p=0.007), and the odds of having perinatal mortality (newborn died within 7 days after birth) was 2.76 times higher (p=0.054) among women living in Alaverdi compared with women living in Artik after adjusting for counfounders. Conclusions. The study showed that living in Alaverdi (proxy measure of being exposed to heavy metals and sulfur dioxide) increases the risk of having stillbirths, induced abortions due to medical indications, and perinatal mortality.