Predictors of Third Trimester Blood Trihalomethanes and Urinary Trichloroacetic Acid Concentrations among Pregnant Women.

ABSTRACT

Prenatal exposure to disinfection byproducts (DBPs) has been associated with a variety of adverse birth outcomes. However, little is known about predictors of prenatal biomarkers of exposure to DBPs among pregnant women. We aimed to identify predictors of third trimester blood trihalomethanes (THMs) and urinary trichloroacetic acid (TCAA) concentrations, two biomarkers of exposure to DBPs, among pregnant women. Blood samples, urine samples, and questionnaires on individual characteristics and water-use activities were collected from 893 pregnant women in a Chinese cohort study. Maternal blood THM [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] and urinary TCAA concentrations were measured. We used multivariable linear regression to identify the predictors of third trimester blood THM and creatinine-adjusted urinary TCAA concentrations. The geometric mean of blood TTHM (sum of TCM, BDCM, DBCM, and TBM) and creatinine-adjusted urinary TCAA concentrations were 51.90 ng/L and 9.66 µg/g creatinine, respectively. Study city was the strongest significant predictors of blood THM and creatinine-adjusted urinary TCAA concentrations. Prenatal body mass index (BMI) was associated with decreased blood THM and decreased creatinine-adjusted urinary TCAA concentrations. Age was associated with increased blood Br-THM (sum of BDCM, DBCM, and TBM) concentrations. Intake of boiled water and passive smoking were associated with lower blood THM concentrations. The predictors of blood THM and urinary TCAA concentrations identified in this study provide potential health implications on how to reduce DBP exposure during pregnancy.