Maternal fluoride exposure, fertility and birth outcomes: The MIREC cohort

Goodman, Carly; Hall, Meaghan; Green, Rivka; Hornung, Richard; Mier, E. Angeles Martinez; Lanphear, Bruce P.; Till, Christine

doi:10.1016/j.envadv.2021.100135

Cited by 8 publications

(5 citation statements)

References 53 publications

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“…A study in Canada with median maternal urinary fluoride of

also found no associations of urinary fluoride levels with the risk of preterm birth or small-for-gestational age. 21 These studies used urinary fluoride concentrations to evaluate the reproductive impacts of exposure to fluoride from all sources, whereas our study estimated the impact of exposure to drinking water fluoride specifically.…”

Section: Discussionmentioning

confidence: 99%

“… 17 , 18 Some studies have found increased risk of preterm birth, 19 others have found the opposite, 16 , 20 and one study found no association with either gestational age or fetal growth. 21 To our knowledge, no studies have been done at the population level, which is an important next step for establishing risk in a general population.…”

Section: Introductionmentioning

confidence: 99%

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Water Fluoridation and Birth Outcomes in California

Goin,

Padula,

Woodruff

et al. 2024

Environ Health Perspect

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Background: There is a lack of research on the relationship between water fluoridation and pregnancy outcomes. Objectives: We assessed whether hypothetical interventions to reduce fluoride levels would improve birth outcomes in California. Methods: We linked California birth records from 2000 to 2018 to annual average fluoride levels by community water system. Fluoride levels were collected from consumer confidence reports using publicly available data and public record requests. We estimated the effects of a hypothetical intervention reducing water fluoride levels to (the current level recommended by the US Department of Health and Human Services) and (below the current recommendation) on birth weight, birth-weight-for-gestational age z -scores, gestational age, preterm birth, small-for-gestational age, large-for-gestational age, and macrosomia using linear regression with natural cubic splines and G-computation. Inference was calculated using a clustered bootstrap with Wald-type confidence intervals. We evaluated race/ethnicity, health insurance type, fetal sex, and arsenic levels as potential effect modifiers. Results: Fluoride levels ranged from 0 to , with a median of . There was a small negative association on birth weight with the hypothetical intervention to reduce fluoride levels to [ ; 95% confidence interval (CI): , 0.0] and to ( ; 95% CI: , ). There were small negative associations with birth-weight-for-gestational-age z -scores for both hypothetical interventions ( : ; 95% CI: , 0.000 and : ; 95% CI: , 0.000). We also observed small negative associations for risk of large-for-gestational age for both the hypothetical interventions to [ ; 95% CI: , 0.000 and ( ; 95% CI: , 0.000)]. We did not observe any associations with preterm birth or with being small for gestational age for either hypothetical intervention. We did not observe any associations with risk of preterm birth or small-for-gestational age for either hypothetical intervention. Conclusion: We estimated that a reduction in water fluoride levels would modestly decrease birth weight and birth-weight-for-gestational-age z -scores in California. https://doi.org/10.1289/EHP13732

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“…A study in Canada with median maternal urinary fluoride of

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Water Fluoridation and Birth Outcomes in California

Goin,

Padula,

Woodruff

et al. 2024

Environ Health Perspect

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“…37 A conceptual model such as a directed acyclic graph can guide variable selection as well as indicate scenarios that might give rise to unanticipated 'backdoor pathways'. 38 In other MIREC articles, some of the MIREC fluoride-IQ authors used a simple version of a directed acyclic graph, 39,40 suggesting that the MIREC fluoride-IQ authors are aware of the value of the organizational tool but chose not to use it in all the articles they created.…”

Section: Lack Of An Appropriate Conceptual Model To Assess Causationmentioning

confidence: 99%

Flawed MIREC fluoride and intelligence quotient publications: A failed attempt to undermine community water fluoridation

Guichon,

Cooper,

Rugg‐Gunn

et al. 2024

Comm Dent Oral Epid

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ObjectiveTo assess the evidence presented in a set of articles that use the Canadian Maternal–Infant Research on Environmental Chemicals (MIREC) study database to claim that community water fluoridation (CWF) is associated with harm to foetal and infant cognitive development.MethodsCritical appraisal of measurements and processes in the MIREC database, and articles derived therefrom. MIREC's cohort is approximately 2000 pregnant women recruited in 10 centres across Canada, 2008–2011, leading to measuring 512 children aged 3–6 years in six cities. Fluoride exposure was measured by city fluoridation status, self‐reports and maternal spot urine samples. Intelligence Quotient (IQ) was measured using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI‐III) by different assessors in each city.ResultsMIREC's fluoride and IQ measurements are invalid and therefore cannot support the claim that CWF is associated with IQ decline in children.ConclusionsThe MIREC fluoride‐IQ articles' results should be considered unacceptable for legal and policy purposes; other water fluoridation studies and systematic reviews show no effect of fluoridation on cognition.

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“…Fluoride also destroys erythrocytes, thereby contributing to the loss of Hb and anaemia. Interestingly, fluoride exposure during pregnancy was not significantly associated with fertility or birth outcomes, especially among women living in areas with levels of fluoride consistent with water fluoridation ( Goodman et al , 2022 ). A study conducted in the United States discovered that greater water fluoride concentrations were connected with a 3.3-month earlier age of menarche ( Malin et al , 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Study of anaemia in pregnancy and low birth weight in fluoride endemic area of Western Rajasthan: a cohort study

Bhardwaj,

Mantri,

Joshi

et al. 2024

F1000Res

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Background Fluoride is a noxious element known to destroy gastrointestinal mucosa, leading to erythrocytes’ destruction and causing anaemia. The birth weight of newborn babies is a significant indicator of a child’s vulnerability to the risk of childhood diseases and chances of existence. Methods This prospective cohort study was planned to find linkages between fluorosis and the low-birth weight of newborn babies with anaemic mothers. Antenatal mothers until the 20th week of gestation were followed up till delivery in the Antenatal Clinic of a District Hospital in one of the known fluoride-endemic districts (Nagaur) and the other not-so-endemic district (Jodhpur) of Western Rajasthan. Results Around 19% of the newborn in Jodhpur and around 22% in Nagaur had low birth weight. Mean fluoride values in water samples were measured to be 0.57 (range from 0.0 to 2.7 PPM) in Jodhpur and 0.7 (range from 0.0 to 3.4 PPM) in Nagaur. Conclusions Thus, in fluoride endemic areas, other factors should be included besides iron and folic acid supplementation for improving anaemia in pregnant women. This calls for assessing the effectiveness of de-fluoridation activities along with the area’s most common indigenous food practices.

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Maternal fluoride exposure, fertility and birth outcomes: The MIREC cohort

Cited by 8 publications

References 53 publications

Water Fluoridation and Birth Outcomes in California

Water Fluoridation and Birth Outcomes in California

Flawed MIREC fluoride and intelligence quotient publications: A failed attempt to undermine community water fluoridation

Study of anaemia in pregnancy and low birth weight in fluoride endemic area of Western Rajasthan: a cohort study

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