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Updated: Jun 3, 2025

Long-term Behavioral and Reproductive Consequences of Embryonic Exposure to Low-dose Toxicants
Published on: March 6, 2018
Meta-analysis and Mendelian randomization study on the association between exposure to chlorinated disinfection
Changxia Cheng1, Yanling Pei2, Guangyu Shan3
1China-Japan Union Hospital of Jilin University Operating Room, Changchun, China.
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.
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