Drinking water disinfection by-products exposure and health effects on pregnancy outcomes : a systematic review
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Date
Authors
Mashau, Funanani
Ncube, Esper Jacobeth
Voyi, K.V.V. (Kuku)
Journal Title
Journal ISSN
Volume Title
Publisher
IWA Publishing
Abstract
Epidemiological studies have found that maternal exposure to disinfection by-products (DBPs) may lead to adverse pregnancy outcomes although the findings tend to be inconsistent. The objective of this study was to systematically review the evidence in association to drinking water DBP exposure in relation to adverse pregnancy outcomes. Peer-reviewed articles were identified using electronic databases searched for studies published in English language. Studies selected for review were evaluated for exposure assessment, confounders, and analyses risks of bias in the selection, outcomes assessment, and attrition. A comprehensive search and screening yielded a total of 32 studies, of which 12 (38%) reported a statistical association between maternal exposure to DBPs and adverse pregnancy outcomes. A maternal exposure to trihalomethanes shows an increased risk of small for gestational age (SGA) and slightly increased risk of pregnancy loss. Risks of bias were low among the studies included in the review. Evidence on association relating to adverse pregnancy outcomes to DBP exposure is still less significant. There is a need for future robust research on this field, with the use of urinary TCCA biomarkers as a direct exposure assessment method for this field.
Description
Keywords
Disinfection by-product (DBP), Drinking water, Small for gestational age (SGA), Low birth weight (LBW), Cohort studies, Duration, Chlorination, Acid exposure, Trihalomethane concentrations, Fetal growth, Preterm birth (PTB)
Sustainable Development Goals
Citation
Mashau, F., Ncube, E.J. & Voyi, K. 2018, 'Drinking water disinfection by-products exposure and health effects on pregnancy outcomes: a systematic review', Journal of Water and Health, vol. 16, no. 2, pp. 181-196.