title: Cyanobacterial (blue-green algae) contamination in drinking water and perinatal outcomes.
abstract: OBJECTIVE
  The aim of this ecological study was to examine the relationship between potential cyanobacterial exposure through drinking water during pregnancy and birth outcomes.
  
  
  METHODS
  One hundred and fifty-six communities in South-Eastern Australia were involved, providing 32,700 singleton live newborn during the period 1992-94. Cyanobacterial occurrence and cell density (alert level) in drinking water sources during the first trimester, the total gestational period for premature births or limited to 36 weeks in term infants, and the last 12 weeks prior to preterm births or up to and including 36 weeks in term infants were used as estimates of exposure.
  
  
  RESULTS
  There were statistically significant differences between the proportion of time during the first trimester with cyanobacterial occurrence and the percentage of births that were low birth weight (LBW) and very low birth rate (VLBW). Significant differences were also found among various categories of first trimester exposure based on average cell density and LBW, prematurity and congenital defects. However, the pattern of these results does not suggest a causal link to cyanobacteria. There were no clear dose-response relationships. Analyses based on exposure during the last 12 weeks and total gestation also showed no significant dose-response effects.
  
  
  CONCLUSIONS
  The results of this study provide no clear evidence for an association between cyanobacterial contamination of drinking water sources and adverse pregnancy outcomes.
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D016001:Confidence Intervals; D000013:Congenital Abnormalities / Q000453:epidemiology*; D000458:Cyanobacteria / Q000302:isolation & purification*; D004326:Drinking; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D012042:Registries; D018570:Risk Assessment; D013021:South Australia / Q000453:epidemiology; D014871:Water Microbiology; D014873:Water Pollutants / Q000009:adverse effects / Q000032:analysis; D014881:Water Supply