Gallagher M D, Nuckols J R, Stallones L, Savitz D A
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, USA.
Epidemiology. 1998 Sep;9(5):484-9.
Exposure during pregnancy to disinfection by-products in drinking water has been hypothesized to lead to several adverse reproductive outcomes. We performed a retrospective cohort study to examine the relation of trihalomethane exposure during the third trimester of pregnancy to low birthweight, term low birthweight, and preterm delivery. We matched Colorado birth certificates from January 1, 1990, through December 31, 1993, to historical water sample data with respect to time and location of maternal residence based on census block groups. After excluding births from all census block groups with no trihalomethane sample data and restricting to singleton white births with 28-42 weeks of completed gestation (>400 gm), we studied 1,893 livebirths within 28 census block groups. We found a weak association of trihalomethane exposure during the third trimester with low birthweight (odds ratio = 2.1 for the highest exposure level; 95% confidence interval = 1.0-4.8); a large increase in risk for term low birthweight at the highest level of exposure (odds ratio = 5.9; 95% confidence interval = 2.0-17.0); and no association between exposure and preterm delivery (odds ratio = 1.0 for the highest exposure level; 95% confidence interval = 0.3-2.8). The small number of adverse outcomes reduced the precision of risk estimates, but these data indicate a potentially important relation between third trimester exposure to trihalomethanes and retarded fetal growth.
孕期接触饮用水中的消毒副产物被认为会导致多种不良生殖结局。我们进行了一项回顾性队列研究，以检验孕期第三个月三卤甲烷暴露与低出生体重、足月低出生体重和早产之间的关系。我们将1990年1月1日至1993年12月31日科罗拉多州的出生证明与基于普查街区组的母亲居住地时间和地点的历史水样数据进行匹配。在排除所有没有三卤甲烷样本数据的普查街区组的出生情况，并将研究限制在妊娠28 - 42周（>400克）的单胎白人出生后，我们在28个普查街区组内研究了1893例活产。我们发现孕期第三个月三卤甲烷暴露与低出生体重之间存在微弱关联（最高暴露水平的优势比 = 2.1；95%置信区间 = 1.0 - 4.8）；在最高暴露水平下，足月低出生体重风险大幅增加（优势比 = 5.9；95%置信区间 = 2.0 - 17.0）；暴露与早产之间无关联（最高暴露水平的优势比 = 1.0；95%置信区间 = 0.3 - 2.8）。不良结局数量较少降低了风险估计的精度，但这些数据表明孕期第三个月接触三卤甲烷与胎儿生长迟缓之间可能存在重要关系。
