WATER NITRATES AND CNS BIRTH-DEFECTS - A POPULATION-BASED CASE-CONTROL STUDY
WATER NITRATES AND CNS BIRTH-DEFECTS - A POPULATION-BASED CASE-CONTROL STUDY
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DOI：
10.1080/00039896.1988.9935846
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发表时间：
1988-03-01
期刊：
影响因子：
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通讯作者：
LO, B
中科院分区：
文献类型：
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作者：
ARBUCKLE, TE;SHERMAN, GJ;LO, B
在加拿大新不伦瑞克省，通过一项病例对照研究，研究了母亲在饮用水中暴露于硝酸盐与分娩中枢神经系统（CNS）畸形婴儿的风险之间的关系。1973-1983年间，新不伦瑞克省“高”患病率和“低”患病率地区的所有中枢神经系统缺陷病例都被纳入研究。对照随机从本省的活产档案中选取，与产妇居住的县和出生日期相匹配。确定了130例病例，并分别与两名对照进行配对。从病例和对照母亲出生或死产记录上的地址中收集了单独的水样。研究表明，水中硝酸盐暴露的影响取决于饮用水的来源是私人水井还是公共市政分配系统。与0.1 ppm的硝酸盐基线水平相比，暴露于26 ppm的私人水井水源的硝酸盐水平与风险的适度增加有关，但没有统计学意义（风险优势比= 2.30；95%置信区间= 0.73-7.29）。如果饮用水的来源是市政供水系统或私人泉水，硝酸盐暴露的增加与分娩中枢神经系统畸形婴儿的风险降低有关；然而，这些效应估计在统计上并不显著。从井水中接触硝酸盐的风险正增加，需要使用更大的病例系列和接触硝酸盐水平超过5ppm的更大比例进行进一步研究。
The relation between maternal exposure to nitrates in drinking water and risk of delivering an infant with a central nervous system (CNS) malformation was examined by means of a case-control study in New Brunswick, Canada. All cases of CNS defects for a “high” and a “low” prevalence area of New Brunswick, for the years 1973–1983, were included in the study. Controls were selected randomly from the livebirth files for the province, matched on county of maternal residence and date of birth. One hundred and thirty (130) cases were identified and individualy matched with two controls each. Individual water samples were collected from the case and control mother's address given on the birth or stillbirth records. The study revealed that the effect of nitrate exposure in water was modified by whether the source of the drinking water was a private well or a public municipal distribution system. Compared to a baseline nitrate level of 0.1 ppm, exposure to nitrate levels of 26 ppm from private well water sources was associated with a moderate, but not statistically significant, increase in risk (risk odds ratio = 2.30; 95% confidence interval = 0.73–7.29). If the source of drinking water was a municipal distribution system or a private spring, an increase in nitrate exposure was associated with a decrease in risk of delivering a CNS-malformed infant; however, these effect estimates were not statistically significant. The positive increase in risk with nitrate exposure from well water sources requires further study using a larger case series and a larger proportion of exposures to nitrate levels exceeding 5 ppm.