title: The effect of water disinfection by-products on pregnancy outcomes in two southeastern US communities.
abstract: OBJECTIVE
  To determine if exposure to disinfection by-products (DBPs) during gestation increases the risk of adverse birth outcomes, specifically term small for gestational age (SGA) birth, preterm birth (PTB), and very PTB (<32 weeks' gestation).
  
  
  METHODS
  We used weekly measurements total trihalomethanes (TTHMs), five haloacetic acids (HAA5), and total organic halides (TOX) collected from two distribution systems to evaluate the associations between DBP concentrations and term SGA, PTB, and very PTB using logistic regression.
  
  
  RESULTS
  We found no associations between DBPs and term-SGA. In the site with higher concentrations of bromine-containing DBPs, we found an association between TOX and PTB; this association was larger, though less precise, for very PTB.
  
  
  CONCLUSIONS
  Our results do not support an association between TTHMs or HAA5 and the birth outcomes investigated, but an association was found between increased TOX and PTB.
authors.affiliation: Departments of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA. bethjab@email.unc.edu
authors.forename: Bethany Jablonski
authors.initials: BJ
authors.lastname: Horton
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Luben
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Philip C
authors.initials: PC
authors.lastname: Singer
authors.forename: Howard S
authors.initials: HS
authors.lastname: Weinberg
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D005865:Gestational Age; D006801:Humans; D006842:Hydrocarbons, Brominated / Q000009:adverse effects / Q000032:analysis*; D006843:Hydrocarbons, Chlorinated / Q000009:adverse effects / Q000032:analysis*; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D015144:Southeastern United States; D022882:Trihalomethanes / Q000009:adverse effects / Q000032:analysis; D018508:Water Purification; D014881:Water Supply / Q000032:analysis; D055815:Young Adult
chemical_list: D006842:Hydrocarbons, Brominated; D006843:Hydrocarbons, Chlorinated; D022882:Trihalomethanes