Predictors of use and consumption of public drinking water among pregnant women

Abstract

Disinfection by-products (DBPs) in drinking water may be associated with adverse pregnancy outcomes. However, the results from previous epidemiological studies are not consistent, perhaps in part due to individual variation in water use and consumption. This study was performed to evaluate and describe demographic and behavioral characteristics as predictors of ingested water, showering, bathing, and swimming among pregnant women. Water use and consumption data were collected through telephone interviews with 2297 pregnant women from three geographical sites in the southern United States. The data were analyzed according to demographic, health, and behavioral variables expected to be predictors of water use and thus potential confounding factors relating water use to pregnancy outcome. The candidate predictors were evaluated using backward elimination in regression models. Demographic variables tended to be more strongly predictive of the use and consumption of water than health and behavior-related factors. NonHispanic white women drank 0.4 (95% confidence interval (CI) 0.2; 0.7) liters more cold tap water per day than Hispanic women and 0.3 (95% CI 0.1; 0.4) liters more than non-Hispanic black women. Non-Hispanic white women also reported drinking a higher proportion of filtered tap water, whereas Hispanic women replaced more of their tap water with bottled water. Lower socioeconomic groups reported spending a longer time showering and bathing, but were less likely to use swimming pools. The results of this study should help researchers to anticipate and better control for confounding and misclassification in studies of exposure to DBPs and pregnancy outcomes.

Variability and predictors of changes in water use during pregnancy

“…In a previously published work (Forssen et al, 2007), we found that season had a strong impact on water use and consumption. Season was, therefore, adjusted for in the regression models in this study.…”

“…There are several previous studies describing the variation of water use in different populations (Windham et al, 1992;Shimokura et al, 1998;Williams et al, 2001;Zender et al, 2001;Barbone et al, 2002;Kaur et al, 2004;King et al, 2004;Forssen et al, 2007), but only three have examined changes in water use during pregnancy (Windham et al, 1992;Shimokura et al, 1998;Barbone et al, 2002). Shimokura et al (1998) assessed the variation in water use based on a 3-day diary among pregnant women in the US.…”

Estimating drinking-water ingestion and dermal contact with water in a French population of pregnant women: the EDDS cohort study

“…Whereas they were older and more often employed than the non-participant women, age and employment have been described as associated only with filtered tap water ingestion during pregnancy, not with total tap water ingestion. 4,10 Estimates of Water Ingestion Tap water ingestion represented 71% of total water ingestion. With similar definition of water ingestion and data collection procedures relatively similar to ours, Forssé n et al 5 7 Proportion of tap water ingestion of EDDS women seemed to be comparable to that in English-speaking countries and lower than that in other Mediterranean countries, such as Italy or Spain.…”

“…They comprised questions chosen following an intensive review of the literature on water-use habits (Supplementary File 4) and exposure assessment questionnaire design. 18 The questionnaires had five sections: (i) socioeconomic data, 19 (ii) medical data, (iii) history of professional exposure, (iv) dermal water exposure, 4,5,[8][9][10] (v) drinking-water and bottled water ingestion frequency, 4-6,8-10 (vi) diet questions (rate of cans, fresh fruit and vegetable consumption), (vii) alcohol and tobacco consumption and (viii) cosmetics type and use frequency.…”

“…[1][2][3][4][5][6][7][8][9][10] Some studies have also assessed predictors of water-use habits during pregnancy. 4,5,9,10 Water ingestion is contingent on geographical and cultural factors; 1 so it is necessary to adapt data to the local context. Only one study has assessed water-use habits of French pregnant women.…”