ArticleEnvironmental epidemiology (Philadelphia, Pa.)2021
Drinking water contaminants in California and hypertensive disorders in pregnancy.
Article in Environmental epidemiology (Philadelphia, Pa.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Nitrate contamination in drinking water and adverse reproductive and birth outcomes: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- The relationship between cadmium exposure and preeclampsia: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Nonlinear association between first-trimester plasma aldosterone concentration and risk of hypertensive disorders of pregnancy: a multicenter prospective cohort study.Frontiers in endocrinology · 2026Article
- Uranium Exposure, Hypertension, and Blood Pressure in the Strong Heart Family Study.Preventing chronic disease · 2025Article
- Environmental Justice Index and adverse pregnancy outcomes.AJOG global reports · 2024Article
- Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021.Current environmental health reports · 2023Article
- Environmental Exposure: Effect on Maternal Morbidity and Mortality and Neonatal Health.Cureus · 2023Review
- Individual, Independent, and Joint Associations of Toxic Metals and Manganese on Hypertensive Disorders of Pregnancy: Results from the MIREC Canadian Pregnancy Cohort.Environmental health perspectives · 2023Article
- Chronic Community Exposure to Environmental Metal Mixtures Is Associated with Selected Cytokines in the Navajo Birth Cohort Study (NBCS).International journal of environmental research and public health · 2022Article
- Genetic Variations in Metallothionein Genes and Susceptibility to Hypertensive Disorders of Pregnancy: A Case-Control Study.Frontiers in genetics · 2022Article
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Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
Environmental pollutants have been associated with hypertensive disorders in pregnancy including gestational hypertension, preeclampsia, and eclampsia, though few have focused on drinking water contamination. Water pollution can be an important source of exposures that may contribute to adverse pregnancy outcomes.
methodsWe linked water quality data on 13 contaminants and two violations from the California Communities Environmental Health Screening Tool to birth records from vital statistics and hospital discharge records (2007-2012) to examine the relationship between drinking water contamination and hypertensive disorders in pregnancy. We examined contaminants in single- and multipollutant models. Additionally, we examined if the relationship between water contamination and hypertensive disorders in pregnancy differed by neighborhood poverty, individual socioeconomic status, and race/ethnicity.
resultsArsenic, nitrate, trihalomethane, hexavalent chromium, and uranium were detected in a majority of water systems. Increased risk of hypertensive disorders in pregnancy was modestly associated with exposure to cadmium, lead, trihalomethane, and hexavalent chromium in drinking water after adjusting for covariates in single pollutant models with odds ratios ranging from 1.01 to 1.08. In multipollutant models, cadmium was consistent, lead and trihalomethane were stronger, and additional contaminants were associated with hypertensive disorders in pregnancy including trichloroethylene, 1,2-Dibromo-3-chloropropane, nitrate, and tetrachloroethylene. Other contaminants either showed null results or modest inverse associations. The relationship between water contaminants and hypertensive disorders in pregnancy did not differ by neighborhood poverty.
conclusionsWe found increased risk of hypertensive disorders in pregnancy associated with exposure to several contaminants in drinking water in California. Results for cadmium, lead, trihalomethane, and hexavalent chromium were robust in multipollutant models.
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Registered trials
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