Pilotto L S, Kliewer E V, Davies R D, Burch M D, Attewell R G
National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory.
Aust N Z J Public Health. 1999 Apr;23(2):154-8. doi: 10.1111/j.1467-842x.1999.tb01226.x.
The aim of this ecological study was to examine the relationship between potential cyanobacterial exposure through drinking water during pregnancy and birth outcomes.
One hundred and fifty-six communities in South-Eastern Australia were involved, providing 32,700 singleton live newborn during the period 1992-94. Cyanobacterial occurrence and cell density (alert level) in drinking water sources during the first trimester, the total gestational period for premature births or limited to 36 weeks in term infants, and the last 12 weeks prior to preterm births or up to and including 36 weeks in term infants were used as estimates of exposure.
There were statistically significant differences between the proportion of time during the first trimester with cyanobacterial occurrence and the percentage of births that were low birth weight (LBW) and very low birth rate (VLBW). Significant differences were also found among various categories of first trimester exposure based on average cell density and LBW, prematurity and congenital defects. However, the pattern of these results does not suggest a causal link to cyanobacteria. There were no clear dose-response relationships. Analyses based on exposure during the last 12 weeks and total gestation also showed no significant dose-response effects.
The results of this study provide no clear evidence for an association between cyanobacterial contamination of drinking water sources and adverse pregnancy outcomes.
本生态研究旨在探讨孕期通过饮用水接触潜在蓝藻与出生结局之间的关系。
澳大利亚东南部的156个社区参与了研究，在1992 - 1994年期间提供了32,700名单胎活产新生儿。将孕早期、早产的整个妊娠期或足月婴儿限于36周时以及早产前最后12周或足月婴儿直至并包括36周时饮用水源中蓝藻的出现情况和细胞密度（警戒水平）用作接触的估计值。
孕早期蓝藻出现时间的比例与低出生体重（LBW）和极低出生率（VLBW）的出生百分比之间存在统计学上的显著差异。基于平均细胞密度以及LBW、早产和先天性缺陷，在孕早期不同接触类别之间也发现了显著差异。然而，这些结果的模式并不表明与蓝藻存在因果关系。没有明确的剂量反应关系。基于最后12周和整个妊娠期接触情况的分析也未显示出显著的剂量反应效应。
本研究结果没有为饮用水源蓝藻污染与不良妊娠结局之间的关联提供明确证据。
