Skip to main content

The Effect of Type of Disinfection and Source Water on Fetal Growth and Preterm Delivery in Massachusetts

Buy Article:

$17.50 plus tax (Refund Policy)

Or sign up for a free trial


We conducted a retrospective cohort study with a semi-ecologic study design examining the type of disinfection and source water in relation to birth outcomes. Consistent with previous studies of preterm delivery (PTD), increased risks were noted for chlorinated water use relative to untreated water (odds ratio (OR)=1.16; 95% confidence intervals (CI): 1.01, 1.33). We also found fairly consistent increased ORs of PTD (range: 1.09 to 1.19) for chlorinated surface water, chlorinated ground water, chloraminated water and all other types of disinfected drinking water relative to untreated ground water. Small increased risks of small for gestational age (SGA) consistent in magnitude (OR range: 1.08 to 1.11) were detected for exposure to chlorinated surface water, chloraminated water, and other water disinfectants relative to untreated ground water. We also found a reduction in mean birth weight for users of chlorinated surface water, chloraminated water, and other water disinfectants (range: 19 to 37 grams) relative to untreated ground water. This is the first study to compare risk of adverse fetal growth indices and PTD among residents using chlorinated, chloraminated and other types of disinfected drinking water. Although we saw small differences for mean birth weight (≤16 grams) among chlorinated surface water users relative to chloraminated surface water users, relative risks for SGA and PTD were fairly comparable. These data suggest that although there may be differences relative to untreated ground water users, risk of adverse birth outcomes among consumers of different types of disinfected drinking water appears to be minimal. Future analyses will focus on examining risk of fetal growth retardation, fetal loss, and birth defects in relation to DBP concentrations independent of type of water source and disinfection practices.

Keywords: Chlorination; Disinfection by-products; Trihalomethanes; birth weight; preterm delivery; small for gestational age

Document Type: Research Article


Publication date: January 1, 2011

More about this publication?
  • Proceedings of the Water Environment Federation is an archive of papers published in the proceedings of the annual Water Environment Federation® Technical Exhibition and Conference (WEFTEC® ) and specialty conferences held since the year 2000. These proceedings are not peer reviewed.

    WEF Members: Sign in (right panel) with your IngentaConnect user name and password to receive complimentary access.
  • Subscribe to this Title
  • Membership Information
  • About WEF Proceedings
  • WEFTEC Conference Information
  • ingentaconnect is not responsible for the content or availability of external websites

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more