Maternal Exposure to Tap Water Disinfection By-Products and Risk of Selected Congenital Heart Defects

IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Birth Defects Research Pub Date : 2024-08-30 DOI:10.1002/bdr2.2391
Adrian M. Michalski, Thomas J. Luben, Ibrahim Zaganjor, Anthony Rhoads, Paul A. Romitti, Kristin M. Conway, Peter H. Langlois, Marcia L. Feldkamp, Wendy N. Nembhard, Jennita Reefhuis, Mahsa M. Yazdy, Angela E. Lin, Tania A. Desrosiers, Adrienne T. Hoyt, Marilyn L. Browne, The National Birth Defects Prevention Study
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Abstract

Background

The use of chlorine to treat drinking water produces disinfection by-products (DBPs), which have been associated with congenital heart defects (CHDs) in some studies.

Methods

Using National Birth Defects Prevention Study data, we linked geocoded residential addresses to public water supply measurement data for DBPs. Self-reported water consumption and filtration methods were used to estimate maternal ingestion of DBPs. We estimated adjusted odds ratios and 95% confidence intervals using logistic regression controlling for maternal age, education, body mass index (BMI), race/ethnicity, and study site to examine associations between CHDs and both household DBP level and estimated ingestion of DBPs.

Results

Household DBP exposure was assessed for 2717 participants (1495 cases and 1222 controls). We observed a broad range of positive, null, and negative estimates across eight specific CHDs and two summary exposures (trihalomethanes and haloacetic acids) plus nine individual DBP species. Examining ingestion exposure among 2488 participants (1347 cases, 1141 controls) produced similarly inconsistent results.

Conclusions

Assessing both household DBP level and estimated ingestion of DBPs, we did not find strong evidence of an association between CHDs and DBPs. Despite a large study population, DBP measurements were available for less than half of participant addresses, limiting study power.

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产妇接触自来水消毒副产物与某些先天性心脏缺陷的风险
背景 使用氯处理饮用水会产生消毒副产物 (DBP),在一些研究中,这些副产物与先天性心脏缺陷 (CHD) 有关。 方法 我们利用全国出生缺陷预防研究的数据,将地理编码的住宅地址与公共供水的 DBPs 测量数据联系起来。通过自我报告的用水量和过滤方法来估算孕产妇摄入的 DBPs。我们使用逻辑回归估算了调整后的几率比例和 95% 的置信区间,并控制了产妇的年龄、教育程度、体重指数 (BMI)、种族/人种和研究地点,以检验先天性心脏病与家庭 DBP 水平和估计摄入的 DBP 之间的关系。 结果 对 2717 名参与者(1495 例病例和 1222 例对照)的家庭 DBP 暴露进行了评估。我们在 8 种特定的 CHD 和 2 种总暴露量(三卤甲烷和卤乙酸)以及 9 种单独的 DBP 中观察到了范围广泛的正估计值、负估计值和负估计值。对 2488 名参与者(1347 例病例、1141 例对照)的摄入暴露进行研究也得出了类似的不一致结果。 结论 通过评估家庭 DBP 水平和估计摄入的 DBPs,我们没有发现心脏病与 DBPs 相关的有力证据。尽管研究人口众多,但只有不到一半的参与者地址可以获得 DBP 测量值,这限制了研究的有效性。
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来源期刊
Birth Defects Research
Birth Defects Research Medicine-Embryology
CiteScore
3.60
自引率
9.50%
发文量
153
期刊介绍: The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.
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