Evidence map›Paper›PMID 41078322›Full record

ArticleBirth defects research2025

Risks of Birth Defects Following In Utero Exposures to Unregulated Brominated Haloacetic Acids.

John A Kaufman, J Michael Wright

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Article in Birth defects research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

John A KaufmanDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.ORCID 0000-0002-4043-3180
J Michael WrightCenter for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Cincinnati, Ohio, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionHaloacetic acids (HAAs) are water disinfection byproducts (DBPs) regulated as a mixture of five species (HAA5) in the United States and Canada. To date, two brominated HAAs (BrHAAs) in HAA5 (monobromoacetic acid [MBAA], dibromoacetic acid [DBAA]) have been associated with birth defects in some epidemiologic studies, but the other four unregulated BrHAAs remain understudied.

methodsWe analyzed registry-based case-control data on 16 birth defect phenotypes in relation to temporally weighted first-trimester exposures to the four unregulated BrHAAs (tribromoacetic acid [TBAA], bromochloroacetic acid [BCAA], bromodichloroacetic acid [BDCAA], chlorodibromoacetic acid [CDBAA]) and the sum of all six BrHAAs (HAA6 = TBAA + BCAA + BDCAA + CDBAA + MBAA + DBAA). We matched cases to controls 1:10 on the week of conception and estimated adjusted odds ratios (aORs) via conditional logistic regression.

resultsWe observed some elevated aORs for dichotomized BrHAA exposures with certain outcomes, such as cleft palate alone (BDCAA aOR = 1.75 [95% confidence interval: 1.15, 2.66]), ventricular septal defects (BDCAA aOR = 1.28 [0.97, 1.68]), tetralogy of Fallot (BDCAA OR = 1.57 [0.93, 2.64]), and obstructive genitourinary defects (CDBAA aOR = 1.65 [1.07, 2.53]), and reduced aORs for hypospadias (e.g., BCAA aOR = 0.58 [0.40, 0.84]). Most other associations were closer to the null, and many lacked precision.

conclusionOur observations warrant further investigation given their novelty and the paucity of data on health impacts of prenatal BrHAA exposures overall; ours is the first epidemiological study to investigate most of these exposure-outcome relationships. Future work would benefit from a longer study period to ascertain additional birth defect cases and more direct exposure assessment in areas served by water systems with higher bromide levels.

Indexed as

AcetatesCongenital AbnormalitiesPrenatal Exposure Delayed EffectsAdultCanadaCase-Control StudiesDisinfectantsFemaleHumansMaleMaternal ExposureOdds RatioPregnancyPregnancy Trimester, FirstRisk FactorsUnited StatesAcetatesDisinfectantsbirth defectsdisinfection byproductshaloacetic acidsmixturesteratogensunregulated contaminantswater

Identifiers

PMID41078322
PMCPMC12516800

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