Swedish workers conducted a nationwide register-based prospective study to assess whether gestational exposure to the four most common chlorination by-products [total trihalomethanes (TTHMs)] via tap water was associated with risk of small for gestational age (SGA), preterm delivery, and very preterm delivery. To date, this is one of the largest studies assessing drinking water TTHM-associated adverse reproductive outcomes, covering over half a million pregnancies.
The results of
the present study provide the evidence that CBP exposure via drinking water is associated with increased risk of SGA in areas with hypochlorite treatment, but not chloramine, potentially due to CBP formation differences. There was no clear association for preterm or very preterm delivery.