Villanueva, Cristina MGracia-Lavedán, EstherIbarluzea, JesúsSanta Marina, LoretoBallester, FerranLlop, SabrinaTardón, AdoninaFernández, Mariana FFreire, CarmenGoñi, FernandoBasagaña, XavierKogevinas, ManolisGrimalt, Joan OSunyer, Jordi2012-11-292012-11-292011-12Villanueva CM, Gracia-Lavedán E, Ibarluzea J, Santa Marina L, Ballester F, Llop S, et al. Exposure to trihalomethanes through different water uses and birth weight, small for gestational age, and preterm delivery in Spain. Environ. Health Perspect.. 2011 Dec; 119(12):1824-300091-6765http://hdl.handle.net/10668/665Reproduced with permission from Environmental Health Perspectives. Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't;BACKGROUND Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive. OBJECTIVE We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LBW), and preterm delivery. METHODS Mother-child cohorts set up in five Spanish areas during the years 2000-2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 measurements), which were modeled and combined with personal water use and uptake factors to estimate personal uptake. We defined outcomes following standard definitions and included 2,158 newborns in the analysis. RESULTS Median residential THM ranged from 5.9 μg/L (Valencia) to 114.7 μg/L (Sabadell), and speciation differed across areas. We estimated that 89% of residential chloroform and 96% of brominated THM uptakes were from showering/bathing. The estimated change of birth weight for a 10% increase in residential uptake was -0.45 g (95% confidence interval: -1.36, 0.45 g) for chloroform and 0.16 g (-1.38, 1.70 g) for brominated THMs. Overall, THMs were not associated with SGA, LBW, or preterm delivery. CONCLUSIONS Despite the high THM levels in some areas and the extensive exposure assessment, results suggest that residential THM exposure during pregnancy driven by inhalation and dermal contact routes is not associated with birth weight, SGA, LBW, or preterm delivery in Spain.enContaminantes Químicos del AguaTrihalometanoEstudios de CohortesExposición a Riesgos AmbientalesFemeninosHumanosRecién Nacido de Bajo PesoRecién nacidoRecién Nacido Pequeño para la Edad GestacionalModelos LogísticosModelos TeóricosEmbarazoNacimiento PrematuroEspañaAdultobirth weightcohort studydisinfection by-productsepidemiologylow birth weightnewbornpremature birthsmall for gestational agetrihalomethaneswater pollutionMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort StudiesMedical Subject Headings::Health Care::Environment and Public Health::Public Health::Environmental Pollution::Environmental ExposureMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Named Groups::Persons::Age Groups::Infant::Infant, Newborn::Infant, Low Birth WeightMedical Subject Headings::Named Groups::Persons::Age Groups::Infant::Infant, NewbornMedical Subject Headings::Named Groups::Persons::Age Groups::Infant::Infant, Newborn::Infant, Low Birth Weight::Infant, Small for Gestational AgeMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic ModelsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, TheoreticalMedical Subject Headings::Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproductive Physiological Processes::Reproduction::PregnancyMedical Subject Headings::Diseases::Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Obstetric Labor Complications::Obstetric Labor, Premature::Premature BirthMedical Subject Headings::Geographicals::Geographic Locations::Europe::SpainMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Halogenated::TrihalomethanesMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Toxic Actions::Environmental Pollutants::Water Pollutants::Water Pollutants, ChemicalMedical Subject Headings::Named Groups::Persons::Age Groups::Adultresearch article21810554open access10.1289/ehp.10024251552-9924