SynthesisEnvironmental research2021
Meta-analysis of small for gestational age births and disinfection byproduct exposures.
Synthesis in Environmental research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 31 citations in OpenAlex.
- Maternal occupational/environmental exposure to selected organic solvents and small-for-gestational-age births: a systematic review and meta-analysis.Journal of exposure science & environmental epidemiology · 2026Review
- Risks of Birth Defects Following In Utero Exposures to Unregulated Brominated Haloacetic Acids.Birth defects research · 2025Article
- A Review of the Evidence of the Toxicity of Chemical Substances Included in the European Union Ambient Air Quality and Drinking Water Directives: Perspectives for Health Impact Assessments.Environment & health (Washington, D.C.) · 2025Review
- Application of Toxicologically Informed Relative Potency Factors to Examine Associations between Water Disinfection Byproducts and Birth Defects.Environmental science & technology · 2025Article
- Community Water Trihalomethanes and Chronic Kidney Disease.JAMA network open · 2025Article
- Advances in understanding the reproductive toxicity of endocrine-disrupting chemicals in women.Frontiers in cell and developmental biology · 2024Review
- Comparison of Trihalomethane exposure assessment metrics in epidemiologic analyses of reproductive and developmental outcomes.Journal of exposure science & environmental epidemiology · 2024Article
- Risks of obstructive genitourinary birth defects in relation to trihalomethane and haloacetic acid exposures: expanding disinfection byproduct mixtures analyses using relative potency factors.Journal of exposure science & environmental epidemiology · 2024Article
- Maternal exposure to nitrosamines in drinking water during pregnancy and birth outcomes in a Chinese cohort.Chemosphere · 2023Article
- Article
- Effects of prenatal and lactational exposure to iodoacetic acid on the F1 generation of mice†.Biology of reproduction · 2022Article
- Iodoacetic acid exposure alters the transcriptome in mouse ovarian antral follicles.Journal of environmental sciences (China) · 2022Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundSome epidemiological studies show associations between disinfection byproducts (DBPs) and adverse developmental outcomes.
objectivesWe undertook a meta-analysis of epidemiological studies on maternal exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) and risk of small for gestational age (SGA) birth.
methodsWe identified forty-five publications including two reports and five theses via a 2020 literature search. Nineteen study populations from 16 publications met the inclusion criteria and were systematically evaluated. Effect measures were pooled using random effects meta-analytic methods along with cumulative, sub-group and meta-regression analyses to examine between-study heterogeneity and variation in risk across different DBP measures.
resultsWe detected a small increased risk for SGA with exposure to the sum of four (i.e., THM4) THM4 (odds ratio (OR) = 1.07; 95%CI: 1.03, 1.11), chloroform (OR = 1.05; 95%CI: 1.01, 1.08), bromodichloromethane (OR = 1.08; 95%CI: 1.05, 1.11) and the sum of the brominated THM4 (OR = 1.05; 95%CI: 1.02, 1.09). Larger ORs were detected for the sum of five haloacetic acids (i.e., HAA5) (OR = 1.12; 95%CI: 1.01, 1.25), dichloroacetic acid (OR = 1.25; 95%CI: 1.01, 1.41) and trichloroacetic acid (OR = 1.21; 95%CI: 1.07, 1.37). We detected larger SGA risks for several THM4 among the prospective cohort and case-control studies compared to retrospective cohorts and for the SGA3/5% (vs. SGA10%) studies. The THM4 meta-regression showed associations between SGA and the total quality score based on categorical or continuous measures. For example, an OR of 1.03 (95%CI: 1.01, 1.06) was detected for each 10-point increase in the study quality score based on our systematic review.
conclusionsWe detected a small increased risk of SGA based on 18 THM4 study populations that was comparable to a previous meta-analysis of eight THM4 study populations. We also found increased risks for other THM4 and HAA measures not previously examined; these results were robust after accounting for outliers, publication bias, type of SGA classification, different exposure windows, and other factors.
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