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  • 标题:Estimated Effects of Disinfection By-products on Preterm Birth in a Population Served by a Single Water Utility
  • 作者:Chad Lewis ; Irwin H. Suffet ; Katherine Hoggatt
  • 期刊名称:Environmental Health Perspectives
  • 印刷版ISSN:0091-6765
  • 电子版ISSN:1552-9924
  • 出版年度:2007
  • 卷号:115
  • 期号:2
  • 页码:290-295
  • DOI:10.1289/ehp.9394
  • 语种:English
  • 出版社:OCR Subscription Services Inc
  • 摘要:Objectives We evaluated the association between drinking-water disinfection by-products and preterm births using improved exposure assessment and more appropriate analysis methods than used in prior studies. Methods During 1999–2001, vital record data were obtained for a large, racially diverse population residing in 27 Massachusetts communities that received drinking water from a single public utility. This water system was monitored weekly for total trihalomethanes (TTHM), and it maintained geographically stable total TTHM levels system-wide during the study period. We employed proportional hazards regression to examine the effects of trimester-specific and shorter-term peak exposures to TTHM in drinking water late in pregnancy on preterm births in 37,498 singletons. Results For all women, our data suggested no more than a small increase, if any, in risk for delivering a preterm baby when exposed to ≥ 60 μg/L TTHM during the 4 weeks before birth [hazard ratio (HR) = 1.13; 95% confidence interval (CI), 0.95–1.35]. However, women who depended on a governmental source of payment for prenatal care were at increased risk when exposed at such levels late in gestation (HR = 1.39; 95% CI, 1.06–1.81). In contrast, exposure to high levels of TTHM during the second trimester and high exposure throughout pregnancy resulted in a 15–18% reduction in risk for preterm delivery in our population. Conclusions This finding confirms previous reports of a negative association during the second trimester. Our data also suggested a possible positive association with shorter-term third-trimester TTHM exposure in mothers of lower socioeconomic status.
  • 关键词:disinfection by-products; environmental exposure; pregnancy second trimester; preterm birth; selective fetal loss; trihalomethanes; water
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