Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark

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Standard

Nitrate in drinking water and risk of birth defects : Findings from a cohort study of over one million births in Denmark. / Stayner, Leslie Thomas; Jensen, Anja ; Schullehner, Jörg; Coffman, Vanessa R.; Trabjerg, Betina B.; Olsen, Jørn; Hansen, Birgitte; Pedersen, Marie; Pedersen, Carsten B.; Sigsgaard, Torben.

In: The Lancet Regional Health - Europe, Vol. 14, 100286, 2022.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Stayner, LT, Jensen, A, Schullehner, J, Coffman, VR, Trabjerg, BB, Olsen, J, Hansen, B, Pedersen, M, Pedersen, CB & Sigsgaard, T 2022, 'Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark', The Lancet Regional Health - Europe, vol. 14, 100286. https://doi.org/10.1016/j.lanepe.2021.100286

APA

Stayner, L. T., Jensen, A., Schullehner, J., Coffman, V. R., Trabjerg, B. B., Olsen, J., Hansen, B., Pedersen, M., Pedersen, C. B., & Sigsgaard, T. (2022). Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark. The Lancet Regional Health - Europe, 14, [100286]. https://doi.org/10.1016/j.lanepe.2021.100286

Vancouver

Stayner LT, Jensen A, Schullehner J, Coffman VR, Trabjerg BB, Olsen J et al. Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark. The Lancet Regional Health - Europe. 2022;14. 100286. https://doi.org/10.1016/j.lanepe.2021.100286

Author

Stayner, Leslie Thomas ; Jensen, Anja ; Schullehner, Jörg ; Coffman, Vanessa R. ; Trabjerg, Betina B. ; Olsen, Jørn ; Hansen, Birgitte ; Pedersen, Marie ; Pedersen, Carsten B. ; Sigsgaard, Torben. / Nitrate in drinking water and risk of birth defects : Findings from a cohort study of over one million births in Denmark. In: The Lancet Regional Health - Europe. 2022 ; Vol. 14.

Bibtex

@article{d5314216039940cbbde85eb2169a9415,
title = "Nitrate in drinking water and risk of birth defects: Findings from a cohort study of over one million births in Denmark",
abstract = "Background: A few studies have reported an increased risk of birth defects (BD) with maternal exposure to nitrate in drinking water. We examined this association in a large cohort study with well-characterized exposure. Methods: Danish singletons liveborn to Danish-born parents from 1991–2013 were identified using civil and patient registries (n=1,018,914). Exposure to nitrate was estimated using a spatial model based on national data linked with individual addresses. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression. Findings: In total, 33,182 cases of BD were identified. Nitrate concentrations were generally well below US and EU standards. We observed an exposure-response relationship (p=0·004) between nitrate during pregnancy and eye BD, and increased risk in the highest exposure group (≥25 mg/L nitrate) (OR: 1·29; 95% CI: 1·00, 1·66). An interaction was observed between maternal age and continuous nitrate exposure for nervous system BD (p<0·001) indicating an increased risk among mothers <25 years-of-age (OR for 10 mg/L (OR10): 1·20; 95% CI: 1·06, 1·35). An interaction (p<0.01) with maternal age and continuous nitrate exposure was also observed for ear, face, and neck BD indicating an increased risk among babies born to mothers <25 years-of-age (OR10: 1·35; 95% CI: 1·11, 1·66). There was evidence of an inverse exposure-response relationship for any, digestive system, female genital, and urinary BD. Interpretation: Our study is the first to report an association between nitrate and eye BD and BD of the ear, face, and neck. It also provides support to prior reports of increased risk of nervous system BD. Funding: This study was supported by a grant from the United States National Institute of Environmental Health Sciences (R01 ES027823-01A1).",
keywords = "Birth Defects, Congenital Malformations, Drinking Water, Nitrate",
author = "Stayner, {Leslie Thomas} and Anja Jensen and J{\"o}rg Schullehner and Coffman, {Vanessa R.} and Trabjerg, {Betina B.} and J{\o}rn Olsen and Birgitte Hansen and Marie Pedersen and Pedersen, {Carsten B.} and Torben Sigsgaard",
note = "Publisher Copyright: {\textcopyright} 2021 The Author(s)",
year = "2022",
doi = "10.1016/j.lanepe.2021.100286",
language = "English",
volume = "14",
journal = "The Lancet Regional Health - Europe",
issn = "2666-7762",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Nitrate in drinking water and risk of birth defects

T2 - Findings from a cohort study of over one million births in Denmark

AU - Stayner, Leslie Thomas

AU - Jensen, Anja

AU - Schullehner, Jörg

AU - Coffman, Vanessa R.

AU - Trabjerg, Betina B.

AU - Olsen, Jørn

AU - Hansen, Birgitte

AU - Pedersen, Marie

AU - Pedersen, Carsten B.

AU - Sigsgaard, Torben

N1 - Publisher Copyright: © 2021 The Author(s)

PY - 2022

Y1 - 2022

N2 - Background: A few studies have reported an increased risk of birth defects (BD) with maternal exposure to nitrate in drinking water. We examined this association in a large cohort study with well-characterized exposure. Methods: Danish singletons liveborn to Danish-born parents from 1991–2013 were identified using civil and patient registries (n=1,018,914). Exposure to nitrate was estimated using a spatial model based on national data linked with individual addresses. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression. Findings: In total, 33,182 cases of BD were identified. Nitrate concentrations were generally well below US and EU standards. We observed an exposure-response relationship (p=0·004) between nitrate during pregnancy and eye BD, and increased risk in the highest exposure group (≥25 mg/L nitrate) (OR: 1·29; 95% CI: 1·00, 1·66). An interaction was observed between maternal age and continuous nitrate exposure for nervous system BD (p<0·001) indicating an increased risk among mothers <25 years-of-age (OR for 10 mg/L (OR10): 1·20; 95% CI: 1·06, 1·35). An interaction (p<0.01) with maternal age and continuous nitrate exposure was also observed for ear, face, and neck BD indicating an increased risk among babies born to mothers <25 years-of-age (OR10: 1·35; 95% CI: 1·11, 1·66). There was evidence of an inverse exposure-response relationship for any, digestive system, female genital, and urinary BD. Interpretation: Our study is the first to report an association between nitrate and eye BD and BD of the ear, face, and neck. It also provides support to prior reports of increased risk of nervous system BD. Funding: This study was supported by a grant from the United States National Institute of Environmental Health Sciences (R01 ES027823-01A1).

AB - Background: A few studies have reported an increased risk of birth defects (BD) with maternal exposure to nitrate in drinking water. We examined this association in a large cohort study with well-characterized exposure. Methods: Danish singletons liveborn to Danish-born parents from 1991–2013 were identified using civil and patient registries (n=1,018,914). Exposure to nitrate was estimated using a spatial model based on national data linked with individual addresses. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression. Findings: In total, 33,182 cases of BD were identified. Nitrate concentrations were generally well below US and EU standards. We observed an exposure-response relationship (p=0·004) between nitrate during pregnancy and eye BD, and increased risk in the highest exposure group (≥25 mg/L nitrate) (OR: 1·29; 95% CI: 1·00, 1·66). An interaction was observed between maternal age and continuous nitrate exposure for nervous system BD (p<0·001) indicating an increased risk among mothers <25 years-of-age (OR for 10 mg/L (OR10): 1·20; 95% CI: 1·06, 1·35). An interaction (p<0.01) with maternal age and continuous nitrate exposure was also observed for ear, face, and neck BD indicating an increased risk among babies born to mothers <25 years-of-age (OR10: 1·35; 95% CI: 1·11, 1·66). There was evidence of an inverse exposure-response relationship for any, digestive system, female genital, and urinary BD. Interpretation: Our study is the first to report an association between nitrate and eye BD and BD of the ear, face, and neck. It also provides support to prior reports of increased risk of nervous system BD. Funding: This study was supported by a grant from the United States National Institute of Environmental Health Sciences (R01 ES027823-01A1).

KW - Birth Defects

KW - Congenital Malformations

KW - Drinking Water

KW - Nitrate

U2 - 10.1016/j.lanepe.2021.100286

DO - 10.1016/j.lanepe.2021.100286

M3 - Journal article

C2 - 35141697

AN - SCOPUS:85122672572

VL - 14

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

SN - 2666-7762

M1 - 100286

ER -

ID: 313929963