Drinking water contaminants and adverse pregnancy outcomes: a review.

Details

• Alternative Title:
  Environ Health Perspect
• Personal Author:
  Bove, Frank ; Shim, Youn ; Zeitz, Perri
• Description:
  Concern for exposures to drinking water contaminants and their effects on adverse birth outcomes has prompted several studies evaluating chlorination disinfection by-products and chlorinated solvents. Some of these contaminants are found to be teratogenic in animal studies. This review evaluates 14 studies on chlorination disinfection by-products such as trihalomethanes (THMs) and five studies on chlorinated solvents such as trichloroethylene (TCE). The adverse birth outcomes discussed in this review include small for gestational age (SGA), low birth weight, preterm birth, birth defects, spontaneous abortions, and fetal deaths. Because of heterogeneities across the studies in the characterization of birth outcomes, the assessment and categorization of exposures, and the levels and mixtures of contaminants, a qualitative review was conducted. Generally, the chief bias in these studies was exposure misclassification that most likely underestimated the risk, as well as distorted exposure-response relationships. The general lack of confounding bias by risk factors resulted from these factors not being associated with drinking water exposures. The studies of THMs and adverse birth outcomes provide moderate evidence for associations with SGA, neural tube defects (NTDs), and spontaneous abortions. Because fewer studies have been conducted for the chlorinated solvents than for THMs, the evidence for associations is less clear. Nevertheless, the findings of excess NTDs, oral clefts, cardiac defects, and choanal atresia in studies that evaluated TCE-contaminated drinking water deserve follow-up.
• Subjects:
  Abortion, Spontaneous Adult Chromosome Aberrations Congenital Abnormalities Disease Models, Animal Disinfectants Female Humans Infant, Low Birth Weight Infant, Newborn Pregnancy Pregnancy Complications Pregnancy Outcome Solvents Trichloroethylene Trihalomethanes Water Pollutants Water Supply

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• Source:
  Environ Health Perspect. 110(Suppl 1):61-74.
• Document Type:
  Journal Article
• Volume:
  110
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:68592752feb12a5babed4592b2b2b5a3fa8e95e866da90e976ccac4ba1d04c15
• Download URL:
  https://stacks.cdc.gov/view/cdc/3915/cdc_3915_DS1.pdf
• File Type:
  [PDF - 584.19 KB ]