Forssén Ulla M, Herring Amy H, Savitz David A, Nieuwenhuijsen Mark J, Murphy Patricia A, Singer Philip C, Wright J Michael
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina 27599-8050, USA.
J Expo Sci Environ Epidemiol. 2007 Mar;17(2):159-69. doi: 10.1038/sj.jes.7500488. Epub 2006 May 3.
Disinfection by-products (DBPs) in drinking water may be associated with adverse pregnancy outcomes. However, the results from previous epidemiological studies are not consistent, perhaps in part due to individual variation in water use and consumption. This study was performed to evaluate and describe demographic and behavioral characteristics as predictors of ingested water, showering, bathing, and swimming among pregnant women. Water use and consumption data were collected through telephone interviews with 2297 pregnant women from three geographical sites in the southern United States. The data were analyzed according to demographic, health, and behavioral variables expected to be predictors of water use and thus potential confounding factors relating water use to pregnancy outcome. The candidate predictors were evaluated using backward elimination in regression models. Demographic variables tended to be more strongly predictive of the use and consumption of water than health and behavior-related factors. Non-Hispanic white women drank 0.4 (95% confidence interval (CI) 0.2; 0.7) liters more cold tap water per day than Hispanic women and 0.3 (95% CI 0.1; 0.4) liters more than non-Hispanic black women. Non-Hispanic white women also reported drinking a higher proportion of filtered tap water, whereas Hispanic women replaced more of their tap water with bottled water. Lower socioeconomic groups reported spending a longer time showering and bathing, but were less likely to use swimming pools. The results of this study should help researchers to anticipate and better control for confounding and misclassification in studies of exposure to DBPs and pregnancy outcomes.
饮用水中的消毒副产物（DBPs）可能与不良妊娠结局有关。然而，以往流行病学研究的结果并不一致，这可能部分归因于用水和饮水量的个体差异。本研究旨在评估和描述人口统计学及行为特征，作为孕妇摄入水、淋浴、盆浴和游泳的预测因素。通过电话访谈来自美国南部三个地理区域的2297名孕妇，收集用水和饮水量数据。根据预期为用水预测因素的人口统计学、健康和行为变量对数据进行分析，这些变量因此也是将用水与妊娠结局相关联的潜在混杂因素。在回归模型中使用向后剔除法对候选预测因素进行评估。与健康和行为相关因素相比，人口统计学变量往往对用水和饮水量具有更强的预测性。非西班牙裔白人女性每天饮用的冷自来水比西班牙裔女性多0.4升（95%置信区间（CI）0.2；0.7），比非西班牙裔黑人女性多0.3升（95%CI 0.1；0.4）。非西班牙裔白人女性还报告称饮用过滤自来水的比例更高，而西班牙裔女性用瓶装水替代了更多的自来水。社会经济地位较低的群体报告淋浴和盆浴时间更长，但使用游泳池的可能性较小。本研究结果应有助于研究人员在DBPs暴露与妊娠结局的研究中预测并更好地控制混杂和错误分类情况。
