Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.

<h4>Background</h4>Few epidemiological studies that have assessed the relation between water disinfection by-products (DBPs) and the risk of stillbirth provide inconsistent results. The objective was to assess the relation between exposure to water disinfection by-products and the risk o...

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Autores principales:	Bing-Fang Hwang, Jouni J K Jaakkola
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/79d09279a3c146ca9b6d70aaa271dd0d
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spelling	oai:doaj.org-article:79d09279a3c146ca9b6d70aaa271dd0d2021-11-18T07:24:24ZRisk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.1932-620310.1371/journal.pone.0033949https://doaj.org/article/79d09279a3c146ca9b6d70aaa271dd0d2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22457804/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Few epidemiological studies that have assessed the relation between water disinfection by-products (DBPs) and the risk of stillbirth provide inconsistent results. The objective was to assess the relation between exposure to water disinfection by-products and the risk of stillbirth.<h4>Methods</h4>We conducted a population-based case-control study of 3,289 cases of stillbirth and a random sample of 32,890 control subjects from 396,049 Taiwanese newborns in 2001-2003 using information from the Birth Registry and Waterworks Registry in Taiwan. We compared the risk of stillbirth in four disinfection by-product exposure categories based on the levels of total trihalomethanes (TTHMs) representing high (TTHMs 20+ µg/L), medium (TTHMs 10-19 µg/L), low exposure (TTHMs 5-9 µg/L), and 0-4 µg/L as the reference category. In addition, we conducted a meta-analysis of the results from the present and 5 previous studies focusing on stillbirth.<h4>Findings</h4>In logistic regression analysis adjusting for gender, maternal age, plurality, conception of season and population density of the municipality where the mother lived during pregnancy, the odds ratio (OR) for stillbirth was 1.10 (95% CI 1.00-1.21) for medium exposure and 1.06 (95% 0.96-1.17) for high exposure compared to reference category. In the meta-analysis, the summary odds ratio for stillbirth (1.11, 95% CI: 1.03, 1.19) was consistently elevated.<h4>Conclusions</h4>The present study is consistent with the hypothesis that the risk of stillbirth is related to prenatal exposure to disinfection by-products. This finding on stillbirth is consistent with previous epidemiologic studies, which strengthens the weight of evidence.Bing-Fang HwangJouni J K JaakkolaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 3, p e33949 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bing-Fang Hwang Jouni J K Jaakkola Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
description	<h4>Background</h4>Few epidemiological studies that have assessed the relation between water disinfection by-products (DBPs) and the risk of stillbirth provide inconsistent results. The objective was to assess the relation between exposure to water disinfection by-products and the risk of stillbirth.<h4>Methods</h4>We conducted a population-based case-control study of 3,289 cases of stillbirth and a random sample of 32,890 control subjects from 396,049 Taiwanese newborns in 2001-2003 using information from the Birth Registry and Waterworks Registry in Taiwan. We compared the risk of stillbirth in four disinfection by-product exposure categories based on the levels of total trihalomethanes (TTHMs) representing high (TTHMs 20+ µg/L), medium (TTHMs 10-19 µg/L), low exposure (TTHMs 5-9 µg/L), and 0-4 µg/L as the reference category. In addition, we conducted a meta-analysis of the results from the present and 5 previous studies focusing on stillbirth.<h4>Findings</h4>In logistic regression analysis adjusting for gender, maternal age, plurality, conception of season and population density of the municipality where the mother lived during pregnancy, the odds ratio (OR) for stillbirth was 1.10 (95% CI 1.00-1.21) for medium exposure and 1.06 (95% 0.96-1.17) for high exposure compared to reference category. In the meta-analysis, the summary odds ratio for stillbirth (1.11, 95% CI: 1.03, 1.19) was consistently elevated.<h4>Conclusions</h4>The present study is consistent with the hypothesis that the risk of stillbirth is related to prenatal exposure to disinfection by-products. This finding on stillbirth is consistent with previous epidemiologic studies, which strengthens the weight of evidence.
format	article
author	Bing-Fang Hwang Jouni J K Jaakkola
author_facet	Bing-Fang Hwang Jouni J K Jaakkola
author_sort	Bing-Fang Hwang
title	Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
title_short	Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
title_full	Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
title_fullStr	Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
title_full_unstemmed	Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.
title_sort	risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in taiwan.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/79d09279a3c146ca9b6d70aaa271dd0d
work_keys_str_mv	AT bingfanghwang riskofstillbirthintherelationtowaterdisinfectionbyproductsapopulationbasedcasecontrolstudyintaiwan AT jounijkjaakkola riskofstillbirthintherelationtowaterdisinfectionbyproductsapopulationbasedcasecontrolstudyintaiwan
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Risk of stillbirth in the relation to water disinfection by-products: a population-based case-control study in Taiwan.

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