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Heavy Metal Pollution and Stillbirth in Bangladesh

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Heavy Metal Pollution and Stillbirth in Bangladesh



1.       Test the hypothesis that exposure to heavy metals is a risk factor for stillbirth in Faridpur, Bangladesh

2.       Identify environmental sources of arsenic, lead, and cadmium exposure among pregnant women in Faridpur, Bangladesh.



Why we care about this

Stillbirth is a devastating outcome for families. Yet determining the causes of and preventing fetal loss has been largely neglected, particularly in the low-income settings that face a disproportionate burden of stillbirth. Bangladesh has one of the highest rates of stillbirth in the world--over one in forty infants is stillborn. Exposure to heavy metals in the environment is also a pressing environmental health threat in Bangladesh, as in many other in low- and middle-income countries. Metal exposure during pregnancy has been associated with certain adverse birth outcomes, yet the link between metals and stillbirth risk remains unclear. The multiple potential exposure routes for these metals, ranging from drinking water to food adulteration, complicate efforts to mitigate risks to maternal health.

Why we see the knowledge we are generating as strategic

We aim to identify the sources of metal exposure among pregnant women in Faridpur, Bangladesh, and the potential role of this exposure in contributing to the elevated rate of stillbirth. To do this, we will leverage the framework of an ongoing child health and mortality prevention surveillance study to compare placental biomarkers of metal exposure among stillbirths and live births in a case-control study. We will evaluate concentrations of various metals in drinking water, soil, rice, and turmeric to identify the likely routes of exposure to metals during pregnancy. This research will inform interventions to reduce pregnant individuals’ exposure to metals during pregnancy and may identify pathways connecting environmental metals to stillbirth, generating policy-relevant data for improving birth outcomes.

What stage on the “Stairway of Research” contribution to problem solving

Stages 1 and 2: 

Stage 1: Identify a problem

Stage 2: Explicate the causal paths that generate the problem


Project Dates

October 2021 – September 30, 2024


Stage of Work

What has been accomplished so far within the project

Enrollment for this project is underway and is anticipated to be completed in December 2023. Our hospital-based study team collected placental samples from all enrolled participants in a sterile lab setting and administered medical history and exposure questionnaires. Hair samples have been collected from approximately 50 participants to date. We have reached our goal of enrolling 100 participants in environmental sampling to characterize sources of metal exposure in the home. Our environmental sampling team collected turmeric, soil, rice, and water from study households. Turmeric and soil were analyzed for metal content at icddr,b in Bangladesh using a handheld X-ray fluorescence analyzer; placenta, water, and rice samples will be shipped to the U.S. for analysis by ICP-MS.

What we are focusing on now

Data collection for this project is ongoing.



Primary Contact:  Allison Sherris

Stanford University

.   Stephen Luby: Medicine

.   Scott Fendorf: Environmental Earth System Science:  Co-PI

.   Gary M. Shaw: Pediatrics:  Co-PI

.   Allison Sherris (former Stanford postdoc, now UW): Project co-lead

.   Ashley Styczynski (former Stanford ID fellow, now CDC): Project co-lead

.   Seth Hoffman, Project Investigator

.   Ahmed Moutwakil, Stanford undergraduate, Research assistant

.   Christlee Elmera, Stanford Postbac, Research assistant


.   Zahid Hossain, Co-PI



Stanford Woods Institute EVP Award 2021:  Protecting Women's Health