title: Is drinking water related to spontaneous abortion? Reviewing the evidence from the California Department of Health Services Studies.
abstract: Because preliminary data suggested a relation between risk of spontaneous abortion and tapwater consumption during pregnancy, the California Department of Health Services included questions on prenatal water consumption in all reproductive studies conducted between 1982 and 1988. Results from four of these five retrospective data bases suggest that women abstaining from tapwater or drinking bottled water during the first trimester of pregnancy may be at reduced risk of spontaneous abortion. Fetal resorption frequencies seen in an accompanying toxicology study were consistent with these epidemiologic findings, although not conclusive. Tap and bottled water samples from these study areas were analyzed for agents that might account for these findings. Differences in trace element composition and biological activity were observed, but the reproductive significance of these differences is unknown. This paper presents an overview of these studies, which are presented in detail separately. Three alternative explanations for these findings--bias, chance, and causality--are reviewed.
authors.affiliation: California Department of Health Services, Berkeley 94704.
authors.forename: S H
authors.initials: SH
authors.lastname: Swan
authors.forename: R R
authors.initials: RR
authors.lastname: Neutra
authors.forename: M
authors.initials: M
authors.lastname: Wrensch
authors.forename: I
authors.initials: I
authors.lastname: Hertz-Picciotto
authors.forename: G C
authors.initials: GC
authors.lastname: Windham
authors.forename: L
authors.initials: L
authors.lastname: Fenster
authors.forename: D M
authors.initials: DM
authors.lastname: Epstein
authors.forename: M
authors.initials: M
authors.lastname: Deane
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology; D001494:Baths; D015982:Bias; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D015984:Causality; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005327:Fetal Resorption; D006801:Humans; D015994:Incidence; D015201:Meta-Analysis as Topic; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012107:Research Design / Q000592:standards; D012189:Retrospective Studies; D014881:Water Supply / Q000032:analysis / Q000592:standards*