Exposure to drinking water pollutants and non-syndromic birth defects: a systematic review and meta-analysis synthesis
Abstract
Objectives: To evaluate the association between drinking water pollutants and non-syndromic birth defects.
Design: Systematic review and meta-analysis synthesis.
Data sources: A search of MEDLINE, EMBASE and Google Scholar was performed to review relevant citations reporting on birth defects in pregnancies exposed to water pollutants between January 1962 and April 2023.
Eligibility criteria: Prospective or retrospective cohort, population studies and case-control studies that provided data on exposure to drinking water pollutants around conception or during pregnancy and non-syndromic birth defects. We included studies published in the English language after the Minamata Bay disaster to reflect on contemporary concerns about the effect of environmental pollution and obstetric outcomes.
Data extraction and synthesis: Two reviewers independently read the retrieved articles for content, data extraction and analysis. The methodological quality of studies was assessed using the Newcastle-Ottawa Scale. Included studies were assessed for comparability when considered for meta-analysis.
Results: 32 studies met inclusion criteria including 17 cohorts (6 389 097 participants) and 15 case-control studies (47 914 cases and 685 712 controls). The most common pollutants investigated were trihalomethanes (11 studies), arsenic (5 studies) and nitrates (4 studies). The studies varied in design with different estimates of exposure, different stages of gestation age and different durations of…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 6 participants or records.
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