Nitrate in Drinking Water during Pregnancy and Spontaneous Preterm Birth: A Retrospective Within-Mother Analysis in California

Sherris, Allison R.; Baiocchi, Michael; Fendorf, Scott; Luby, Stephen P.; Yang, Wei; Shaw, Gary M.

doi:10.1289/ehp8205

Cited by 46 publications

(44 citation statements)

References 51 publications

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“…Only three epidemiologic studies of nitrate in drinking water and PTB have previously been conducted, all of which were in the United States. These US studies all provide some evidence for an association between nitrate in drinking water and PTB 7–9 ; however, two were based on ecologic estimates of nitrate exposure and all of them were based on birth in areas with high nitrate concentrations and possible pesticide exposure. Maternal consumption of nitrosatable drugs along with dietary intake of nitrite during pregnancy has been associated with increased risk of PTB in a survey-based study of liveborn infants in the US National Birth Defects Prevention Study.…”

Section: Introductionmentioning

confidence: 99%

Prenatal exposure to nitrate from drinking water and the risk of preterm birth

Coffman

Jensen

Trabjerg

et al. 2022

Environmental Epidemiology

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Background: Evidence is emerging that preterm birth (PTB, birth before 37 completed weeks of gestation), a risk factor for neonatal mortality and future morbidity, may be induced by maternal nitrate ( ) exposure from drinking water. The objective of this study is to assess the association between maternal exposure to nitrate and the risk of PTB in a nationwide study of liveborn singletons. Methods: We estimated maternal nitrate exposure from household tap water for 1,055,584 births in Denmark to Danish-born parents during 1991–2015 by linkage of individual home address(es) with nitrate concentrations from a national monitoring database. Nitrate exposure during pregnancy was modeled using four categories and continuously. Logistic models adjusted for sex, birth year, birth order, urbanicity, and maternal age, smoking, education, income, and employment, with generalized estimating equations were used to account for sibling clusters. Results: A total of 1,009,189 births were included, comprising 51,747 PTB. An increase in the risk of PTB was seen across categories of exposure (P < 0.001) with an odds ratio (OR) in the uppermost category (>25 mg/L nitrate) of 1.05 (95% confidence interval [CI] = 1.00, 1.10). Evidence of an exposure–response relationship was observed in models using continuous nitrate (OR = 1.01 [95% CI = 1.00, 1.03] per 10 mg/L nitrate). In sensitivity analyses, results were robust to the addition of variables for short inter-pregnancy interval (<1 year between births), maternal pre-pregnancy body mass index, paternal socioeconomic status and age, season of birth, and inclusion of post-term births. Results were virtually unchanged when the analysis was restricted to women exposed to less than the current European Union standard of 50 mg/L. Conclusion: We observed an increasing risk of PTB with increases in nitrate in household tap water. These findings add to a growing body of evidence of adverse effects from nitrate in drinking water at levels below current regulatory levels.

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Section: Introductionmentioning

confidence: 99%

Prenatal exposure to nitrate from drinking water and the risk of preterm birth

Coffman

Jensen

Trabjerg

et al. 2022

Environmental Epidemiology

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“…Diffuse source contamination occurs when a low (but higher than natural) concentration of the contaminant is spread across a large area, such as from the use of fertilizers on croplands or cattle grazing for an extended period of time [6,8]. The effects of nitrogen contamination have been, and continue to be, documented for both individual lifeforms [9][10][11][12] and ecosystems [13]. However, there is scarce understanding of the effects of nitrogen contamination in groundwater ecosystems, particularly those residing in situ within the aquifer matrix.…”

Section: Introductionmentioning

confidence: 99%

The Variation in Groundwater Microbial Communities in an Unconfined Aquifer Contaminated by Multiple Nitrogen Contamination Sources

Morrissy

Currell

Reichman

et al. 2022

Water

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Aquifers provide integral freshwater resources and host ecosystems of largely uncharacterized, truncated endemic microorganisms. In recent history, many aquifers have become increasingly contaminated from various anthropogenic sources. To better understand the impacts of nitrogen contamination on native groundwater ecosystems, 16S rRNA sequencing of the groundwater microbial communities was carried out. Samples were taken from an aquifer known to be contaminated with nitrogen from multiple sources, including fertilizers and wastewater treatment plant effluents. In total, two primary contaminants were identified: NH4+ (<0.1–3.7–26 mg L−1 NH4+ min-median-max), and NO3− (<0.01–18–150 mg L−1 NO3− min-median-max). These contaminants were found to be associated with a decrease/increase in microbial species richness within affected groundwater for NH4+/NO3−, respectively. Important phyla were identified, including Proteobacteria, which had the highest abundance within samples unaffected by NH4+ (36–81% NH4+ unaffected, 4–33% NH4+ affected), and Planctomycetes (0.05–10% NH4+ unaffected, 43–72% NH4+ affected), which had the highest abundance within the NH4+ affected samples, likely due to its ability to perform anaerobic ammonia oxidation (ANAMMOX). Planctomycetes were identified as a potential indicator for the presence of NH4+ contamination. The analysis and characterization of sequencing data alongside physicochemical data showed potential to increase the depth of our understanding of contaminant behavior and fate within a contaminated aquifer using this type of data and analysis.

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“…Since then, regulatory agencies in the US and World Health Organization (WHO) have imposed similar limits of 10 mg/L NO 3 ‐N (US) and 50 mg/L NO 3 (WHO, or 11.3 mg/L NO 3 ‐N) for drinking water (USEPA, 2021; WHO, 2017). Epidemiological reviews (Ward et al., 2005, 2018) identified multiple studies linking drinking water with nitrate below these regulatory limits to a variety of cancers (Inoue‐Choi et al., 2015; Jones et al., 2016; McElroy et al., 2008; Schullehner et al., 2018; Stayner et al., 2021; Ward et al., 2010) and adverse pregnancy outcomes (Brender et al., 2013; Coffman et al., 2021; Holtby et al., 2014; Manasaram et al., 2006; Sherris et al., 2021; Weyer et al., 2014), although some studies report no association (Mattix & Winchester, 2007; Mueller et al., 2004; Waller et al., 2010; Winchester et al., 2009). Increased risk (expressed via odds ratio or hazard ratio) could be found at concentrations as low as 0.7–5 mg/L NO 3 ‐N (Espejo‐Herrera, Gracia‐Lavedan, Boldo, et al., 2016; Espejo‐Herrera, Gracia‐Lavedan, Pollan, et al., 2016; Fan & Steinberg, 1996; Holtby et al., 2014; Inoue‐Choi et al., 2015; Schullehner et al., 2018; Temkin et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Examining Relationships Between Groundwater Nitrate Concentrations in Drinking Water and Landscape Characteristics to Understand Health Risks

et al. 2022

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Nitrate in drinking water has been identified as a pollutant that can be hazardous to human health since the mid-1940s, when nitrate ingestion from well water was linked to fatal blue baby syndrome (Comly, 1945;Faucett & Miller, 1946;Ferrant, 1946). Since then, regulatory agencies in the US and World Health Organization (WHO) have imposed similar limits of 10 mg/L NO 3 -N (US) and 50 mg/L NO 3 (WHO, or 11.3 mg/L NO 3 -N) for drinking water (USEPA, 2021; WHO, 2017). Epidemiological reviews (Ward et al., 2005(Ward et al., , 2018 identified multiple studies linking drinking water with nitrate below these regulatory limits to a variety of cancers (Inoue-

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Nitrate in Drinking Water during Pregnancy and Spontaneous Preterm Birth: A Retrospective Within-Mother Analysis in California

Cited by 46 publications

References 51 publications

Prenatal exposure to nitrate from drinking water and the risk of preterm birth

Prenatal exposure to nitrate from drinking water and the risk of preterm birth

The Variation in Groundwater Microbial Communities in an Unconfined Aquifer Contaminated by Multiple Nitrogen Contamination Sources

Examining Relationships Between Groundwater Nitrate Concentrations in Drinking Water and Landscape Characteristics to Understand Health Risks

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