title: Water disinfection by-products and pre-labor rupture of membranes.
abstract: The causes of term pre labor rupture of membranes (term PROM) remain poorly defined. The authors conducted a record-based prevalence study to explore a possible relation between disinfection by-products in drinking water and term PROM in an Australian community with spatially variable trihalomethane and nitrate levels. A multilevel statistical model was used to examine the relation between factors operating at the levels of the individual, district, and water distribution zone and the prevalence of PROM at term among 16,229 women in Perth, Western Australia (2002-2004). Adjusted odds ratios for term PROM increased with increasing tertiles of nitrate exposure (moderate exposure: odds ratio = 1.23, 95% confidence interval: 1.03, 1.52; high exposure: odds ratio = 1.47, 95% confidence interval: 1.20, 1.79), but there was no significant relation with exposure to trihalomethanes. This study raises the possibility that water contaminants may promote the development of PROM at term.
authors.affiliation: School of Population Health, University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Joyce
authors.forename: Angus
authors.initials: A
authors.lastname: Cook
authors.forename: John
authors.initials: J
authors.lastname: Newnham
authors.forename: Michael
authors.initials: M
authors.lastname: Brenters
authors.forename: Chantal
authors.initials: C
authors.lastname: Ferguson
authors.forename: Philip
authors.initials: P
authors.lastname: Weinstein
mesh_terms: D002713:Chlorine / Q000009:adverse effects* / Q000032:analysis; D002849:Chromatography, Gas; D016001:Confidence Intervals; D004202:Disinfectants / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D013058:Mass Spectrometry; D009566:Nitrates / Q000009:adverse effects / Q000032:analysis; D009602:Nitrosamines / Q000009:adverse effects / Q000032:analysis; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D022882:Trihalomethanes / Q000009:adverse effects / Q000032:analysis; D014874:Water Pollutants, Chemical / Q000009:adverse effects / Q000032:analysis; D018508:Water Purification / Q000379:methods*; D014881:Water Supply; D014904:Western Australia / Q000453:epidemiology
chemical_list: D004202:Disinfectants; D009566:Nitrates; D009602:Nitrosamines; D022882:Trihalomethanes; D014874:Water Pollutants, Chemical; D002713:Chlorine