Table 3.
Adjusted odds ratios (aORs) between disinfection by-product (DBP) exposures and obstructive genital defects (OGD).
| Cases/ controlsa | Adjustedb | Further adjusted for DBP co-exposuresc | |||
|---|---|---|---|---|---|
| DBP metric (μg/L) | OR | 95% CI | OR | 95% CI | |
| DBP9 | |||||
| 0–28.15 | 36/420 | 1.00 | Referent | -- | -- |
| >28.15–59.35 | 47/420 | 1.39 | 0.87, 2.25 | -- | -- |
| >59.35–80.16 | 45/420 | 1.32 | 0.81, 2.14 | -- | -- |
| >80.16–99.08 | 35/421 | 1.02 | 0.62, 1.69 | -- | -- |
| >99.08–215.42 | 47/419 | 1.39 | 0.86, 2.25 | -- | -- |
| THM4 | |||||
| 0–18.81 | 36/420 | 1.00 | Referent | 1.00 | Referent |
| >18.81–38.02 | 43/420 | 1.28 | 0.79, 2.08 | 1.32 | 0.77, 2.27 |
| >38.02–51.65 | 46/420 | 1.36 | 0.84, 2.20 | 1.43 | 0.79, 2.58 |
| >51.65–66.67 | 37/420 | 1.11 | 0.67, 1.83 | 1.18 | 0.61, 2.28 |
| >66.67–121.40 | 48/420 | 1.43 | 0.88, 2.33 | 1.54 | 0.77, 3.09 |
| THMBr | |||||
| 0–5.53 | 53/699 | 1.00 | Referent | 1.00 | Referent |
| >5.53–8.64 | 74/700 | 1.52 | 1.01, 2.28 | 1.53 | 1.00, 2.34 |
| >8.64–51.84 | 83/699 | 1.74 | 1.16, 2.59 | 1.74 | 1.15, 2.64 |
| Chloroform | |||||
| 0–10.67 | 36/420 | 1.00 | Referent | 1.00 | Referent |
| >10.67–29.66 | 44/421 | 1.31 | 0.81, 2.14 | 1.35 | 0.79, 2.30 |
| >29.66–42.32 | 45/417 | 1.34 | 0.82, 2.18 | 1.40 | 0.76, 2.59 |
| >42.32–55.98 | 37/422 | 1.11 | 0.67, 1.85 | 1.18 | 0.59, 2.33 |
| >55.98–97.03 | 48/418 | 1.44 | 0.89, 2.33 | 1.52 | 0.76, 3.06 |
| BDCM | |||||
| 0–5.05 | 54/701 | 1.00 | Referent | 1.00 | Referent |
| >5.05–7.61 | 71/698 | 1.41 | 0.95, 2.11 | 1.46 | 0.94, 2.25 |
| >7.61–46.37 | 85/699 | 1.70 | 1.16, 2.50 | 1.75 | 1.15, 2.65 |
| DBCM | |||||
| 0 | 49/647 | 1.00 | Referent | 1.00 | Referent |
| >0–14.65 | 161/1451 | 1.72 | 1.16, 2.54 | 1.71 | 1.15, 2.54 |
| Bromoform | |||||
| 0 | 174/1754 | 1.00 | Referent | 1.00 | Referent |
| >0–6.83 | 36/344 | 1.04 | 0.70, 1.55 | 1.08 | 0.72, 1.63 |
| HAA9 | |||||
| 0–10.10 | 36/413 | 1.00 | Referent | 1.00 | Referent |
| >10.10–23.28 | 42/413 | 1.23 | 0.76, 1.99 | 1.05 | 0.58, 1.90 |
| >23.28–29.40 | 48/413 | 1.43 | 0.88, 2.31 | 1.14 | 0.59, 2.24 |
| >29.40–38.41 | 38/413 | 1.11 | 0.68, 1.83 | 0.86 | 0.41, 1.81 |
| >38.41–179.50 | 40/413 | 1.18 | 0.72, 1.96 | 0.89 | 0.40, 1.97 |
| HAA5 | |||||
| 0–7.07 | 37/420 | 1.00 | Referent | 1.00 | Referent |
| >7.07–18.84 | 46/420 | 1.31 | 0.82, 2.10 | 1.10 | 0.60, 2.02 |
| >18.84–25.34 | 46/420 | 1.33 | 0.82, 2.14 | 1.06 | 0.53, 2.10 |
| >25.34–33.86 | 40/420 | 1.17 | 0.72, 1.91 | 0.90 | 0.42, 1.92 |
| >33.86–120.59 | 41/420 | 1.14 | 0.70, 1.87 | 0.86 | 0.38, 1.91 |
| HAA4 | |||||
| 0–2.52 | 52/689 | 1.00 | Referent | 1.00 | Referent |
| >2.52–3.72 | 89/687 | 1.90 | 1.29, 2.78 | 2.11 | 1.35, 3.29 |
| >3.72–121.62 | 63/689 | 1.26 | 0.83, 1.90 | 1.37 | 0.87, 2.15 |
| TCAA | |||||
| 0–4.65 | 44/519 | 1.00 | Referent | 1.00 | Referent |
| >4.65–10.86 | 57/519 | 1.39 | 0.90, 2.14 | 1.28 | 0.73, 2.24 |
| >10.86–16.41 | 60/520 | 1.47 | 0.95, 2.25 | 1.30 | 0.67, 2.53 |
| >16.41–91.14 | 45/520 | 1.06 | 0.67, 1.67 | 0.93 | 0.45, 1.92 |
| DCAA | |||||
| 0–4.76 | 52/520 | 1.00 | Referent | 1.00 | Referent |
| >4.76–10.38 | 55/520 | 1.10 | 0.73, 1.68 | 0.88 | 0.53, 1.44 |
| >10.38–13.62 | 45/519 | 0.87 | 0.56, 1.35 | 0.63 | 0.35, 1.11 |
| >13.62–38.25 | 54/519 | 1.12 | 0.73, 1.72 | 0.77 | 0.42, 1.41 |
| MCAA | |||||
| 0 | 103/1033 | 1.00 | Referent | 1.00 | Referent |
| >0–32.21 | 103/1045 | 0.99 | 0.74, 1.33 | 0.90 | 0.65, 1.25 |
| DBAA | |||||
| 0 | 151/1597 | 1.00 | Referent | 1.00 | Referent |
| >0–23.58 | 55/481 | 1.23 | 0.88, 1.72 | 1.23 | 0.88, 1.72 |
| MBAA | |||||
| 0 | 201/2029 | 1.00 | Referent | 1.00 | Referent |
| >0–4.75 | 5/49 | 0.95 | 0.37, 2.46 | 0.95 | 0.37, 2.45 |
| BCAA 25th | |||||
| 0–0.66 | 43/516 | 1.00 | Referent | 1.00 | Referent |
| >0.66–29.76 | 161/1549 | 1.31 | 0.91, 1.89 | 1.33 | 0.86, 2.06 |
| BDCAA 25th | |||||
| 0–1.05 | 41/516 | 1.00 | Referent | 1.00 | Referent |
| >1.05–55.85 | 163/1549 | 1.42 | 0.98, 2.05 | 1.56 | 0.97, 2.51 |
| CDBAA 25th | |||||
| 0–0.04 | 36/517 | 1.00 | Referent | 1.00 | Referent |
| >0.04–30.59 | 168/1548 | 1.74 | 1.17, 2.59 | 1.97 | 1.23, 3.15 |
| TBAA (25th) | |||||
| 0.0003 | 36/518 | 1.00 | Referent | 1.00 | Referent |
| >0.0003–5.41 | 168/1547 | 1.71 | 1.15, 2.54 | 1.90 | 1.20, 3.03 |
| HAABr | |||||
| 0–2.06 | 44/516 | 1.00 | Referent | 1.00 | Referent |
| >2.06–3.23 | 55/517 | 1.36 | 0.88, 2.09 | 1.31 | 0.79, 2.15 |
| >3.23–4.41 | 43/514 | 1.03 | 0.64, 1.64 | 0.98 | 0.57, 1.71 |
| >4.41–122.54 | 62/518 | 1.48 | 0.96, 2.27 | 1.43 | 0.89, 2.31 |
| DBPBr | |||||
| 0–6.12 | 32/413 | 1.00 | Referent | 1.00 | Referent |
| >6.12–9.21 | 35/413 | 1.12 | 0.67, 1.89 | 1.15 | 0.62, 2.12 |
| >9.21–11.47 | 47/412 | 1.65 | 1.00, 2.70 | 1.68 | 0.94, 3.01 |
| >11.47–17.02 | 38/415 | 1.25 | 0.75, 2.10 | 1.28 | 0.70, 2.33 |
| >17.02–174.39 | 52/412 | 1.77 | 1.10, 2.87 | 1.80 | 1.05, 3.10 |
| DBPCl | |||||
| 0–17.86 | 35/416 | 1.00 | Referent | 1.00 | Referent |
| >17.86–50.18 | 52/416 | 1.57 | 0.98, 2.52 | 1.69 | 0.72, 3.94 |
| >50.18–71.28 | 38/415 | 1.15 | 0.69, 1.92 | 1.23 | 0.52, 2.94 |
| >71.28–89.60 | 36/414 | 1.11 | 0.67, 1.85 | 1.21 | 0.50, 2.91 |
| >89.60–208.46 | 45/415 | 1.37 | 0.84, 2.24 | 1.46 | 0.61, 3.49 |
| HAACl | |||||
| 0–6.53 | 38/416 | 1.00 | Referent | 1.00 | Referent |
| >6.53–18.83 | 45/414 | 1.22 | 0.76, 1.96 | 0.94 | 0.51, 1.71 |
| >18.83–25.19 | 44/417 | 1.21 | 0.75, 1.96 | 0.84 | 0.42, 1.69 |
| >25.19–33.76 | 41/415 | 1.17 | 0.72, 1.90 | 0.76 | 0.36, 1.64 |
| >33.76-max | 38/416 | 1.03 | 0.62, 1.70 | 0.65 | 0.29, 1.46 |
| DBP13 | |||||
| 0–22.44 | 29/344 | 1.00 | Referent | -- | -- |
| >22.44–57.30 | 34/346 | 1.23 | 0.72, 2.10 | -- | -- |
| >57.30–73.68 | 37/342 | 1.33 | 0.77, 2.30 | -- | -- |
| >73.68–89.68 | 34/343 | 1.29 | 0.75, 2.23 | -- | -- |
| >89.68–105.30 | 34/346 | 1.25 | 0.73, 2.15 | -- | -- |
| >105.30–256.31 | 36/344 | 1.30 | 0.76, 2.24 | -- | -- |
| HAA3 | |||||
| 0–6.58 | 37/416 | 1.00 | Referent | 1.00 | Referent |
| >6.58–18.43 | 44/414 | 1.22 | 0.76, 1.97 | 0.99 | 0.54, 1.81 |
| >18.43–24.83 | 46/415 | 1.31 | 0.81, 2.12 | 0.98 | 0.48, 1.97 |
| >24.83–32.63 | 41/416 | 1.18 | 0.73, 1.92 | 0.84 | 0.39, 1.81 |
| >32.63–120.06 | 38/411 | 1.07 | 0.65, 1.78 | 0.74 | 0.32, 1.68 |
| TCAA + DCAA | |||||
| 0–6.23 | 38/416 | 1.00 | Referent | 1.00 | Referent |
| >6.23–18.31 | 44/415 | 1.19 | 0.74, 1.91 | 0.91 | 0.50, 1.66 |
| >18.31–24.78 | 46/413 | 1.28 | 0.79, 2.07 | 0.89 | 0.44, 1.78 |
| >24.78–32.51 | 41/417 | 1.15 | 0.71, 1.86 | 0.75 | 0.35, 1.60 |
| >32.51–120.06 | 37/411 | 1.01 | 0.61, 1.67 | 0.63 | 0.28, 1.43 |
| THM4 + TCAA | |||||
| 0–23.21 | 37/416 | 1.00 | Referent | 1.00 | Referent |
| >23.21–48.67 | 43/416 | 1.23 | 0.76, 1.99 | 1.26 | 0.76, 2.08 |
| >48.67–66.84 | 47/415 | 1.38 | 0.85, 2.23 | 1.35 | 0.82, 2.22 |
| >66.84–83.96 | 31/416 | 0.89 | 0.53, 1.49 | 0.88 | 0.52, 1.51 |
| >83.96–185.97 | 48/415 | 1.41 | 0.87, 2.28 | 1.29 | 0.77, 2.16 |
a
Case and control distribution prior to modeling.
b
Adjusted for maternal education (less than high school; high school graduate or GED; some college, associates, or technical degree; college degree), 2000 US Census tract income (continuous), number of prenatal care visits ( < 9; 9–11; 12; 13–15; >15), prenatal care payment source (private health insurance; Medicaid or CommonHealth; other including Medicare and Healthy Start), maternal smoking (yes;no), maternal age ( < 20; 20- < 35; ≥35).
c
Further adjusted for DBP co-exposures: adjusted for HAA5 (THM4, THMBr, chloroform, BDCM, DBCM, bromoform), THM4 (HAA9, HAA5, TCAA, DCAA, MCAA, TBAA, DBAA, MBAA, BCAA, BDCAA, CDBAA, HAA3, TCAA + DCAA), DBPCl (DBPBr), DBPBr (DBPCl), THM4 and HAACl (HAABr), THM4 and HAABr (HAACl), or HAABr only (THM4 + TCAA).