title: Environmental and urinary markers of prenatal exposure to drinking water disinfection by-products, fetal growth, and duration of gestation in the PELAGIE birth cohort (Brittany, France, 2002-2006).
abstract: Although prenatal exposure to water disinfection by-products does not appear to affect the duration of gestation, its impact on fetal growth remains an open question. The authors studied the associations between prenatal exposure to disinfection by-products and fetal growth restriction (FGR) and preterm birth in the PELAGIE cohort, a French birth cohort comprising 3,421 pregnant women recruited between 2002 and 2006. Exposure was assessed by estimating levels of trihalomethanes (THMs) in tap water during pregnancy and maternal water use and by measuring maternal urinary levels of trichloroacetic acid (TCAA) during early pregnancy in a nested case-control design that compared 174 FGR cases, 114 preterm births, and 399 controls. Higher uptake of THMs (especially brominated THMs) was associated with a higher risk of FGR. Women with TCAA detected in their urine (>0.01 mg/L) had a higher risk of FGR than those with TCAA levels below the detection limit (adjusted odds ratio = 1.8, 95% confidence interval: 0.9, 3.7) and had an odds ratio for preterm birth below 1 (adjusted odds ratio = 0.8, 95% confidence interval: 0.3, 2.6). Results from this prospective study, the first to use a biomarker of disinfection by-product exposure, suggest that prenatal exposure affects fetal growth, but the causal agent or agents remain to be identified.
authors.affiliation: INSERM U, Institut de Recherches sur la Santé, l’Environnement et le Travail, University of Rennes, Institut Fédératif de Recherches, France. nathalie.costet@univ-rennes1.fr
authors.forename: Nathalie
authors.initials: N
authors.lastname: Costet
authors.forename: Ronan
authors.initials: R
authors.lastname: Garlantézec
authors.forename: Christine
authors.initials: C
authors.lastname: Monfort
authors.forename: Florence
authors.initials: F
authors.lastname: Rouget
authors.forename: Bertrand
authors.initials: B
authors.lastname: Gagnière
authors.forename: Cécile
authors.initials: C
authors.lastname: Chevrier
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Cordier
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D004202:Disinfectants / Q000009:adverse effects* / Q000032:analysis; D004327:Drinking Behavior; D060766:Drinking Water / Q000737:chemistry*; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced*; D005602:France; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D011247:Pregnancy; D047928:Premature Birth / Q000139:chemically induced*; D011446:Prospective Studies; D014238:Trichloroacetic Acid / Q000009:adverse effects* / Q000652:urine; D022882:Trihalomethanes / Q000009:adverse effects* / Q000032:analysis; D018508:Water Purification
chemical_list: D015415:Biomarkers; D004202:Disinfectants; D060766:Drinking Water; D022882:Trihalomethanes; D014238:Trichloroacetic Acid