Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, PR China.
Chemosphere. 2023 Feb;315:137776. doi: 10.1016/j.chemosphere.2023.137776. Epub 2023 Jan 6.
Maternal exposure to regulated disinfection by-products (DBPs) during pregnancy has been linked with adverse birth outcomes. However, no human studies have focused on drinking water nitrosamines, a group of emerging unregulated nitrogenous DBPs that exhibits genotoxicity and developmental toxicity in experimental studies. This cohort study included 2457 mother-infant pairs from a single drinking water supply system in central China, and maternal trimester-specific and entire pregnancy exposure of drinking water nitrosamines were evaluated. Multivariable linear and Poisson regression models were used to estimate the associations between maternal exposure to nitrosamines in drinking water and birth outcomes [birth weight (BW), low birth weight (LBW), small for gestational age (SGA) and preterm delivery (PTD)]. Elevated maternal N-nitrosodimethylamine (NDMA) exposure in the second trimester and N-nitrosopiperidine (NPIP) exposure during the entire pregnancy were associated with decreased BW (e.g., β = -88.6 g; 95% CI: -151.0, -26.1 for the highest vs. lowest tertile of NDMA; p for trend = 0.01) and increased risks of PTD [e.g., risk ratio (RR) = 2.16; 95% CI: 1.23, 3.79 for the highest vs. lowest tertile of NDMA; p for trend = 0.002]. Elevated maternal exposure of N-nitrosodiethylamine (NDEA) in the second trimester was associated with increased risk of SGA (RR = 1.80; 95% CI: 1.09, 2.98 for the highest vs. lowest tertile; p for trend = 0.01). Our study detected associations of maternal exposure to drinking water nitrosamines during pregnancy with decreased BW and increased risks of SGA and PTD. These findings are novel but require replication in other study populations.
母体在怀孕期间暴露于受管制的消毒副产物（DBPs）与不良出生结局有关。然而，目前还没有研究关注饮用水亚硝胺，这是一组新兴的不受管制的含氮 DBPs，在实验研究中表现出遗传毒性和发育毒性。这项队列研究包括来自中国中部单一饮用水供应系统的 2457 对母婴，评估了母亲在怀孕期间特定的和整个怀孕期间饮用水中亚硝胺的暴露情况。使用多变量线性和泊松回归模型来估计母亲暴露于饮用水中亚硝胺与出生结局[出生体重（BW）、低出生体重（LBW）、小于胎龄儿（SGA）和早产（PTD）]之间的关联。在妊娠中期母体 N-亚硝基二甲胺（NDMA）暴露升高和整个妊娠期间 N-亚硝基哌啶（NPIP）暴露与 BW 降低有关（例如，最高与最低 tertile 之间的 BW 差异为 -88.6g；95%CI：-151.0，-26.1；p for trend = 0.01），并且 PTD 的风险增加[例如，最高与最低 tertile 之间的 RR 为 2.16；95%CI：1.23，3.79；p for trend = 0.002]。在妊娠中期母体 N-亚硝基二乙胺（NDEA）暴露升高与 SGA 的风险增加有关（RR 为 1.80；95%CI：1.09，2.98；p for trend = 0.01）。我们的研究检测到母体在怀孕期间暴露于饮用水亚硝胺与 BW 降低以及 SGA 和 PTD 风险增加有关。这些发现是新颖的，但需要在其他研究人群中复制。
