Table 3.
Adjusted odds ratios (aORs) between disinfection by-product (DBP) exposures and congenital anomalies of the heart and circulatory system (All CVD), conotruncal heart defects, transposition of the great arteries (TGA), and tetralogy of Fallot (TOF).
| DBP metrics (μg/L)a | All CVDc | Conotruncald | TGAe | TOFf | ||||
|---|---|---|---|---|---|---|---|---|
| Casesb (n) | aOR (95% CI) | Casesb (n) | aOR (95% CI) | Casesb (n) | aOR (95% CI) | Casesb (n) | aOR (95% CI) | |
| THM4g | ||||||||
| > 23.05–38.05 | 184 | 1.04 (0.72, 1.51) | 37 | 0.96 (0.43, 2.14) | 21 | 1.70 (0.58, 4.95) | 17 | 0.32 (0.10, 1.05) |
| > 38.05–50.41 | 188 | 1.02 (0.67, 1.54) | 45 | 1.19 (0.50, 2.82) | 26 | 1.87 (0.57, 6.08) | 19 | 0.51 (0.15, 1.74) |
| > 50.41–65.27 | 192 | 1.04 (0.67, 1.62) | 32 | 0.68 (0.27, 1.74) | 13 | 1.02 (0.28, 3.82) | 19 | 0.31 (0.08, 1.21) |
| > 65.27–125.32 | 167 | 0.81 (0.51, 1.31) | 31 | 0.50 (0.17, 1.48) | 15 | 0.81 (0.17, 3.84) | 16 | 0.19 (0.04, 0.88) |
| THMBrg | ||||||||
| > 4.17–6.04 | 173 | 0.99 (0.65, 1.51) | 39 | 0.72 (0.32, 1.60) | 14 | 0.45 (0.13, 1.61) | 25 | 1.00 (0.34, 2.98) |
| > 6.04–7.80 | 195 | 1.05 (0.71, 1.55) | 39 | 0.60 (0.27, 1.30) | 26 | 0.98 (0.35, 2.74) | 12 | 0.23 (0.06, 0.91) |
| > 7.80–11.51 | 176 | 0.97 (0.66, 1.42) | 32 | 0.47 (0.21, 1.02) | 14 | 0.49 (0.16, 1.49) | 18 | 0.45 (0.14, 1.39) |
| > 11.51–42.48 | 188 | 1.02 (0.71, 1.46) | 34 | 0.39 (0.19, 0.80) | 19 | 0.55 (0.20, 1.51) | 16 | 0.26 (0.09, 0.76) |
| Chloroformg | ||||||||
| > 12.07–29.99 | 181 | 1.05 (0.73, 1.50) | 33 | 1.22 (0.56, 2.65) | 19 | 1.49 (0.53, 4.24) | 14 | 0.50 (0.16, 1.53) |
| > 29.99–42.17 | 197 | 1.03 (0.68, 1.55) | 46 | 1.46 (0.62, 3.47) | 25 | 1.69 (0.52, 5.50) | 21 | 0.76 (0.22, 2.69) |
| > 42.17–55.41 | 184 | 0.94 (0.60, 1.47) | 37 | 1.42 (0.53, 3.79) | 15 | 1.28 (0.33, 4.95) | 22 | 0.81 (0.20, 3.29) |
| > 55.41–98.99 | 167 | 0.77 (0.47, 1.25) | 29 | 0.63 (0.21, 1.93) | 15 | 0.55 (0.11, 2.83) | 14 | 0.33 (0.07, 1.64) |
| Bromodichloromethane (BDCM)g | ||||||||
| > 4.95–7.55 | 325 | 0.97 (0.73, 1.28) | 61 | 0.73 (0.40, 1.34) | 36 | 0.83 (0.37, 1.86) | 24 | 0.49 (0.19, 1.24) |
| > 7.55–37.38 | 286 | 0.93 (0.72, 1.19) | 51 | 0.49 (0.29, 0.82) | 24 | 0.57 (0.27, 1.22) | 28 | 0.38 (0.17, 0.82) |
| Dibromochloromethane (DBCM)g | ||||||||
| > 3.93–14.53 | 87 | 1.01 (0.77, 1.33) | 16 | 0.68 (0.36, 1.29) | 10 | 1.01 (0.43, 2.39) | 7 | 0.54 (0.20, 1.41) |
| Bromoformg | ||||||||
| > 0.26–7.06 | 109 | 1.43 (1.10, 1.86) | 25 | 1.30 (0.72, 2.33) | 16 | 2.42 (1.12, 5.23) | 10 | 1.14 (0.45, 2.87) |
| HAA5h | ||||||||
| > 8.17–19.33 | 160 | 0.99 (0.69, 1.42) | 38 | 1.18 (0.53, 2.66) | 17 | 0.86 (0.28, 2.64) | 21 | 2.13 (0.53, 8.65) |
| > 19.33–25.79 | 219 | 1.42 (0.95, 2.12) | 49 | 3.19 (1.29, 7.89) | 29 | 4.54 (1.26, 16.41) | 21 | 4.98 (1.02, 24.35) |
| > 25.79–33.97 | 172 | 1.35 (0.87, 2.10) | 37 | 3.76 (1.38, 10.24) | 19 | 4.26 (1.02, 17.87) | 17 | 5.88 (1.06, 32.57) |
| > 33.97–100.00 | 174 | 1.18 (0.75, 1.86) | 24 | 1.77 (0.63, 4.97) | 9 | 1.10 (0.23, 5.37) | 16 | 6.51 (1.23, 34.59) |
| Trichloroacetic acid (TCAA)h | ||||||||
| > 5.23–11.09 | 234 | 1.17 (0.86, 1.60) | 59 | 2.09 (1.02, 4.29) | 30 | 1.38 (0.53, 3.56) | 28 | 2.72 (0.91, 8.13) |
| > 11.09–16.38 | 237 | 1.11 (0.76, 1.62) | 44 | 2.13 (0.89, 5.14) | 22 | 1.39 (0.40, 4.80) | 22 | 4.30 (1.09, 16.88) |
| > 16.38–73.39 | 208 | 1.03 (0.69, 1.55) | 36 | 1.95 (0.77, 4.92) | 18 | 1.07 (0.29, 3.86) | 19 | 3.89 (0.97, 15.66) |
| Dichloroacetic acid (DCAA)h | ||||||||
| > 5.18–10.44 | 219 | 1.04 (0.78, 1.40) | 48 | 1.07 (0.57, 2.04) | 27 | 0.96 (0.41, 2.23) | 22 | 1.39 (0.50, 3.88) |
| > 10.44–13.85 | 241 | 1.21 (0.86, 1.70) | 52 | 1.60 (0.76, 3.36) | 28 | 1.21 (0.43, 3.41) | 24 | 3.08 (0.92, 10.34) |
| > 13.85–38.89 | 220 | 1.23 (0.85, 1.78) | 34 | 1.16 (0.50, 2.70) | 12 | 0.50 (0.14, 1.77) | 21 | 3.34 (0.90, 12.43) |
| Monochloroacetic acid (MCAA)h | ||||||||
| > 1.53–62.39 | 84 | 1.06 (0.80, 1.40) | 9 | 0.85 (0.41, 1.77) | 6 | 1.10 (0.43, 2.77) | 4 | 0.83 (0.27, 2.54) |
| Monobromoacetic acid (MBAA)h | ||||||||
| > 0.04–10.63 | 24 | 1.17 (0.66, 2.07) | 4 | 0.77 (0.17, 3.48) | 1 | 0.47 (0.06, 3.97) | 3 | 0.80 (0.08, 7.48) |
| Dibromoacetic acid (DBAA)h | ||||||||
| > 0.47–21.78 | 73 | 0.81 (0.61, 1.08) | 19 | 0.72 (0.39, 1.33) | 11 | 0.96 (0.41, 2.26) | 7 | 0.59 (0.23, 1.54) |
| DBP9 | ||||||||
| > 33.07–59.95 | 187 | 1.37 (0.95, 1.97) | 37 | 1.11 (0.52, 2.37) | 21 | 1.22 (0.45, 3.31) | 17 | 0.80 (0.24, 2.63) |
| > 59.95–79.13 | 196 | 1.30 (0.87, 1.92) | 49 | 1.12 (0.51, 2.49) | 24 | 0.87 (0.29, 2.61) | 24 | 1.15 (0.32, 4.08) |
| > 79.13–97.67 | 194 | 1.37 (0.92, 2.05) | 36 | 1.23 (0.54, 2.78) | 19 | 1.02 (0.34, 3.11) | 18 | 1.39 (0.39, 5.01) |
| > 97.67–181.59 | 160 | 0.96 (0.63, 1.46) | 24 | 0.36 (0.14, 0.95) | 10 | 0.08 (0.01, 0.46) | 14 | 0.94 (0.23, 3.79) |
| Note: CI, confidence interval; DBP9, sum of chloroform, BDCM, DBCM, bromoform, MCAA, DCAA, TCAA, MBAA, and DBAA; HAA5, sum of MCAA, DCAA, TCAA, MBAA, and DBAA; THM4, sum of chloroform, BDCM, DBCM, and bromoform; THMBr, sum of BDCM, DBCM, and bromoform. aFor each DBP metric, the referent for each model includes exposure scores of zero up to the lower bound of the lowest exposure category.bThe numbers represent the case distribution across exposure groups before modeling.cModels adjusted for the type of water source and treatment, infant birth weight, town-level income quartile, number of prenatal care visits (< 9, 9–11, 12, 13–15, > 15), health index (gestational diabetes, non-gestational diabetes, chronic hypertension, gestational hypertension, and hydramnios/oligohydramnios), and other maternal reproductive risk factors.dModels adjusted for the type of water source and treatment, health index (gestational diabetes, non-gestational diabetes, chronic hypertension, gestational hypertension, and hydramnios/oligohydramnios), and other maternal reproductive risk factors.eModels adjusted for the type of water source and treatment, number of prenatal care visits (< 9, 9–11, 12, 13–15, > 15), ZIP code–level income quartile, trimester prenatal care began (first, after first), health index (gestational diabetes, nongestational diabetes, chronic hypertension, gestational hypertension, and hydramnios/oligohydramnios), and other maternal reproductive risk factors.fModels adjusted for the type of water source and treatment, infant birth weight, ZIP code–level income quartile, trimester prenatal care began (first, after first), health index (gestational diabetes, nongestational diabetes, chronic hypertension, gestational hypertension, and hydramnios/oligohydramnios), and other maternal reproductive risk factors.gModels also include adjustment for HAA5 concentrations.hModels also include adjustment for THM4 concentrations. | ||||||||