Office of Air Quality Planning and Standards, Office of Air and Radiation, US Environmental Protection Agency, Research Triangle Park, North Carolina.
Oak Ridge Institute for Science Education (ORISE) at the National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina.
Birth Defects Res. 2017 Feb 15;109(3):193-202. doi: 10.1002/bdra.23569.
Water and water-based beverages constitute a major part of daily fluid intake for pregnant women, yet few epidemiologic studies have investigated the role of water consumption on birth outcomes.
We used data from the National Birth Defects Prevention Study to conduct a case-control study investigating associations between maternal water consumption during pregnancy and birth defects (BD). We used interview data on water consumption during the first trimester of pregnancy in 14,454 cases (major BDs n ≥ 50) and 5,063 controls. Total water consumption was analyzed as a continuous variable and in quartiles. We evaluated the role of dietary quality and sugar sweetened beverage consumption. Logistic regression models were used to assess effects of water consumption on risk of BDs with adjustment for relevant covariates.
Mean daily maternal water consumption among controls was 4.4 eight-ounce glasses. We observed decreases in estimated risk associated with increases in water consumption for several BDs, including neural tube defects (spina bifida), oral clefts (cleft lip), musculoskeletal defects (gastroschisis, limb deficiencies), and congenital heart defects (hypoplastic left heart syndrome, right-sided obstructions, pulmonary valve stenosis). Our results were generally unchanged when an indicator for overall dietary quality was included; however, there was evidence of effect measure modification by heavy consumption of sugar-sweetened beverages for some defects, but not all.
These analyses suggest the importance of sufficient water consumption during early pregnancy, above and beyond it being a marker of higher diet quality. Additional analyses are warranted to understand the biological mechanism for this association. Birth Defects Research 109:193-202, 2017. © 2016 Wiley Periodicals, Inc.
水和水基饮料构成了孕妇日常液体摄入的主要部分，但很少有流行病学研究调查水的摄入量对出生结果的影响。
我们使用国家出生缺陷预防研究的数据进行了一项病例对照研究，调查了孕妇怀孕期间的水消耗与出生缺陷（BD）之间的关系。我们使用了 14454 例（主要 BD n≥50）和 5063 例对照的妊娠早期水消耗的访谈数据。总水消耗被分析为连续变量和四分位数。我们评估了饮食质量和含糖饮料消耗的作用。逻辑回归模型用于评估水消耗对 BD 风险的影响，调整了相关协变量。
对照组中母亲的平均日用水量为 4.4 杯八盎司的杯子。我们观察到，随着水消耗的增加，与几种 BD 相关的估计风险降低，包括神经管缺陷（脊柱裂）、口腔裂（唇裂）、肌肉骨骼缺陷（腹裂、肢体缺陷）和先天性心脏病缺陷（左心发育不全综合征、右侧梗阻、肺动脉瓣狭窄）。当包含总体饮食质量的指标时，我们的结果基本不变；然而，对于一些缺陷，有证据表明与大量饮用含糖饮料有关的效应量修饰，但并非所有缺陷都有这种修饰。
这些分析表明，在妊娠早期充分饮水的重要性，超出了它作为更高饮食质量的标志。需要进一步分析以了解这种关联的生物学机制。出生缺陷研究 109:193-202,2017。 © 2016 Wiley 期刊，公司。
