Skip Navigation LinksHome > May 2010 - Volume 21 - Issue 3 > Exposure to Disinfection By-products, Fetal Growth, and Prem...
Epidemiology:
doi: 10.1097/EDE.0b013e3181d61ffd
Perinatal: Review Article

Exposure to Disinfection By-products, Fetal Growth, and Prematurity: A Systematic Review and Meta-analysis

Grellier, Jamesa; Bennett, Jamesa; Patelarou, Evridikib; Smith, Rachel B.a; Toledano, Mireille B.a; Rushton, Lesleya; Briggs, David J.a; Nieuwenhuijsen, Mark J.a,c

Supplemental Author Material
Collapse Box

Abstract

Background: Exposure to total trihalomethanes in drinking water has been associated with several adverse birth outcomes relating to fetal growth and prematurity.

Methods: We carried out a systematic review and meta-analysis of epidemiologic studies featuring original peer-reviewed data on the association of total trihalomethane exposure and health outcomes related to fetal growth and prematurity.

Results: A comprehensive literature search yielded 37 studies, 15 of which were selected for the extraction of relative risks relating adverse birth outcomes to trihalomethane exposure. Sufficient data were available for meta-analyses to be carried out for 4 adverse birth outcomes: low birth weight (LBW), term low birth weight (term LBW), preterm delivery, and small for gestational age (SGA) (including intra uterine growth retardation). We found little or no evidence for associations between third trimester trihalomethane exposure and LBW (odds ratio per 10 μg total trihalomethane/L = 1.00 [95% confidence interval = 0.97–1.03]), term LBW (1.03 [0.93–1.15]), or preterm delivery (0.99 [0.98–1.00]), but some evidence for SGA (1.01 [1.00–1.02]).

Conclusions: There was little or no evidence for associations between total trihalomethane concentration and adverse birth outcomes relating to fetal growth and prematurity, with the possible exception of SGA. We discuss these findings and the uncertainties—relating particularly to exposure—that may have affected them.

© 2010 Lippincott Williams & Wilkins, Inc.

Twitter  Facebook

Login

Article Tools

Share