Prenatal drinking-water exposure to tetrachloroethylene and ischemic placental disease: a retrospective cohort study

Abstract

BackgroundPrenatal drinking water exposure to tetrachloroethylene (PCE) has been previously related to intrauterine growth restriction and stillbirth. Pathophysiologic and epidemiologic evidence linking these outcomes to certain other pregnancy complications, including placental abruption, preeclampsia, and small-for-gestational-age (SGA) (i.e., ischemic placental diseases), suggests that PCE exposure may also be associated with these events. We examined whether prenatal exposure to PCE-contaminated drinking water was associated with overall or individual ischemic placental diseases.MethodsUsing a retrospective cohort design, we compared 1,091 PCE-exposed and 1,019 unexposed pregnancies from 1,766 Cape Cod, Massachusetts women. Exposure between 1969 and 1990 was estimated using water distribution system modeling software. Data on birth weight and gestational age were obtained from birth certificates; mothers self-reported pregnancy complications.ResultsOf 2,110 eligible pregnancies, 9% (N = 196) were complicated by ≥1 ischemic placental disease. PCE exposure was not associated with overall ischemic placental disease (for PCE ≥ sample median vs. no exposure, risk ratio (RR): 0.90; 95% confidence interval (CI): 0.65, 1.24), preeclampsia (RR: 0.36; 95% CI: 0.12-1.07), or SGA (RR: 0.98; 95% CI: 0.66-1.45). However, pregnancies with PCE exposure ≥ the sample median had 2.38-times the risk of stillbirth ≥27 weeks gestation (95% CI: 1.01, 5.59), and 1.35-times of the risk of placental abruption (95% CI: 0.68, 2.67) relative to unexposed pregnancies.ConclusionsPrenatal PCE exposure was not associated with overall ischemic placental disease, but may increase risk of stillbirth.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-72) contains supplementary material, which is available to authorized users.

Residential Proximity to Roadways and Ischemic Placental Disease in a Cape Cod Family Health Study

“…Data used in this analysis were collected for the Cape Cod Family Health Study, a population-based retrospective cohort study initiated in 2002 to examine the effects of exposure to perchloroethylene (PCE) through contaminated drinking water on reproductive and childhood health [ 30 , 31 , 32 ]. A detailed description of the cohort has been published elsewhere [ 33 ]. Briefly, women who gave birth to at least one child (identified here as “index” pregnancies) and resided in one of eight Cape Cod towns ( Figure 1 ) between 1969 and 1983 were eligible for inclusion in the study.…”

“…We also examined the association between traffic exposure and stillbirth and vaginal bleeding, conditions which may result from placental dysfunction. Lastly, we ran models including stillbirth in the definition of ischemic placental disease, as has been done by other researchers [ 33 ].…”

Association of prenatal and early life exposure to tetrachloroethylene (PCE) with polycystic ovary syndrome and other reproductive disorders in the cape cod health study: A retrospective cohort study

“…In a prospective cohort study in women with occupational exposure to organic solvent, the occurrence of a major fetal malformation was increased among women with a risk ratio of 13 (95% CI: 1.8–99.5) [17]. Additionally, associations have been previously reported from this cohort between prenatal PCE exposure and neurological outcomes such as color vision deficits, diminished performance on neuropsychological tests of visuospatial functioning, learning and memory, motor, attention and mood [18–20], stillbirths (RR: 2.38, 95% CI: 1.01–5.59), placental abruption (RR:1.35, 95% CI: 0,68–2.67) [21], central nervous system birth defects (OR: 3.1, 95% CI: 0.9–11.0) and oral clefts (OR: 3.2, 95% CI: 0.7–15) [22]. However, few studies have assessed the association of prenatal PCE exposure and PCOS, as well as other adult onset reproductive disorders in women.…”

Modeled exposure to tetrachloroethylene-contaminated drinking water and the risk of placenta-related stillbirths: a case-control study from Massachusetts and Rhode Island

“…Epidemiological studies of women with occupational exposure to dry cleaning solvents have also observed positive associations for pregnancy loss [ 22 , 23 ]. However, only a few studies have examined fetal deaths among women exposed in community settings via contaminated drinking water [ 24 – 28 ]. Two of these studies found increases in the risk of fetal death among highly exposed women, but the results were based on a small number of cases [ 26 , 28 ].…”