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Maternal Exposure to Tap Water Disinfection By-Products and Risk of Selected Congenital Heart Defects
Journal article   Open access   Peer reviewed

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

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, …
Birth defects research, Vol.116(9), e2391
09/2024
DOI: 10.1002/bdr2.2391
PMCID: PMC11440226
PMID: 39212068
url
https://doi.org/10.1002/bdr2.2391View
Published (Version of record) Open Access

Abstract

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.
congenital heart defects disinfection by-products ingestion public water supply

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