LAUSR

Objective: To explore the associations between exposure to chlorination disinfection by-products (CDBPs) during gestation and newborns' small for gestational age (SGA). Methods: During April 2010 to July 2012, a total of 3 903 pregnant women who lived in a district with the same water treatment plant in Wuhan, China were recruited to this perspective study. Information about demographic characteristics of pregnant women and their newborns was collected. The tap water samples were monthly collected for 28 months in 3 different sites, with 84 samples, and 4 kinds of trihalomethanes (THMs)(chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)) and 2 kinds of chlorohaloacetic acids (HAAs) (trichloroacetic acid (TCAA), dichloroacetic acid (DCAA)) were determined. The pregnant women were divided into 4 groups(Q1 to Q4) by quartile method according to their exposure level of CDBPs. Binary Logistic regression models were used to assess the associations between exposure to CDBPs during gestation and newborns' small for gestational age. Results: The average weight of all the newborns was (3 310.19±389.91) g, of which 169 (4.33%) were SGA. The median concentrations of TCM, BDCM, bromo-THMs, total THMs, TCAA, and DCAA during the whole pregnancy were 18.07, 4.93, 8.51, 26.74, 10.65, and 13.77 μg/L, respectively. Binary Logistic regression analysis showed dose-response relationships between elevated TCM and total THMs during the whole gestation and compared with Q1 group, while there was a increased risk of SGA in Q4 group, and OR(95%CI) was 1.87 (1.01-3.49) , 2.30 (1.22-4.35) , respectively (P for trend equaled to 0.044, 0.015). Compare with Q1 group, there also be positive associations between exposure to TCAA (Q4 group) during first-trimester and the whole gestation and SGA, while OR(95%CI) was 2.16 (1.19-3.91) (P for trend equaled to 0.015). Conclusion: Exposure to CDBPs during gestation might increase the risk of newborns' SGA.