Exposure To Drinking Water Trihalomethanes During Early Pregnancy In Relation To Neonatal Neurobehavioral Development

Objective: To investigate the effect of exposure to drinking water trihalomethanes(THMs)during early pregnancy on neonatal neurological development,using THMs in blood as internal biomarkers of exposure.Methods: During March 2015 to June 2016,early pregnant women(<14 weeks)who came to the Maternal and Child Care Service Centre of Xiaonan District,Xiaogan to make prenatal examination were recruited to finish a questionnaire,and provided a blood sample on the day of their clinic visit.The neonatal neurological development of their newborns was assessed using neonatal behavioral neurological assessment(NBNA)on the third day after birth.Four THMs including chloroform(TCM),bromodichloromethane(BDCM),dibromochloromethane(DBCM)and bromoform(TBM)were determined using the method of headspace solid phase micro-extraction gas chramatography(HS-SPEM-GC).Multivariable linear regression models were used to assess the associations between blood THMs concentrations and parameters of neonatal neurological development.Results: From March 2015 to June 2016,a total of 283 cases of single live newborns were conducted with neonatal neurological development assessment.Multivariable linear regressions showed significant dose-response relationship between elevated blood TCM of pregnant woman and reduced NBNA score in newborns(p for trend=0.014).Compared to woman in the lowest tertiles of TCM,newborns of pregnant women in the highest exposure group had average decreases of 0.98(95% CI:-1.77,-0.19)in neonates' NBNA score.Conclusions: Elevated blood THMs levels during early pregnancy were associated with reduced neonates' NBNA score,indicating that exospore to drinking water THMs during pregnancy may adversely affect neonatal neurobehavioral development.