Meta-analysis and Mendelian randomization study on the association between exposure to chlorinated disinfection byproducts and preterm birth risk

Changxia Cheng; Yanling Pei; Guangyu Shan; Yutao Liu

doi:10.1038/s41372-024-02195-9

Meta-analysis and Mendelian randomization study on the association between exposure to chlorinated disinfection byproducts and preterm birth risk

J Perinatol. 2025 Jan 9. doi: 10.1038/s41372-024-02195-9. Online ahead of print.

Authors

Changxia Cheng^#¹, Yanling Pei^#², Guangyu Shan³, Yutao Liu⁴

Affiliations

¹ China-Japan Union Hospital of Jilin University Operating Room, Changchun, China.
² China-Japan Union Hospital of Jilin University Nursing Department, Changchun, China.
³ Department of Beihu Campus, China-Japan Union Hospital of Jilin University Emergency, Changchun, China.
⁴ China-Japan Union Hospital of Jilin University Central Sterile Supply Department, Changchun, China. [email protected].

^# Contributed equally.

PMID: 39789297
DOI: 10.1038/s41372-024-02195-9

Abstract

Objective: This study aims to investigate the correlation between exposure to disinfection byproducts of chlorination and preterm birth (PTB) through evidence-based medicine Meta-analysis and Mendelian randomization (MR) analysis.

Study design: Meta-analysis was conducted on 17 studies involving 1,251,426 neonates, revealing a higher risk of PTB with exposure to total trihalomethanes (TTHMs) and chloroform. Mendelian randomization (MR) analysis confirmed a causal relationship between chlorides and PTB.

Results: TTHMs and chloroform were associated with increased PTB risk, while haloacetic acids showed no significant association. TTHMs were linked to small gestational age. Ethnicity and study design influenced heterogeneity.

Conclusions: Exposure to chlorination byproducts, particularly TTHMs and chloroform, poses a significant risk for PTB. MR analysis supports a causal relationship between chlorides and PTB, highlighting the importance of water disinfection byproduct control in preventing PTB.