Variability and predictors of changes in water use during pregnancy

Abstract

Disinfection by-products in tap water have been found in some studies to be associated with adverse pregnancy outcomes, but little is known about how water use and consumption might change during early pregnancy. Estimating water-related activities only at one time during pregnancy could easily lead to exposure misclassification. To evaluate changes in water use among pregnant women, we used data from a large epidemiologic study in which 1990 women were interviewed around 9 and 20 weeks' gestation. The water variables that were examined included ingestion of cold and hot tap water as well as of bottled water, showering and bathing. Changes were detected between early and mid-pregnancy for ingested cold tap water and showering. Thirtythree percent of the subjects changed cold-water ingestion by Z1.0 liters/day and 44% changed their time showering by Z35 min per week during this period. Increases in cold tap water intake were associated with age 435 years, income o$40,000, and non-Hispanic white ethnicity. We also found that the proportion of the total variation due to within-subject variability was 62% for hot tap water ingestion but only 35% for showering and B50% for cold tap water, bottled water and bathing. Limited resources in epidemiologic studies often require a decision between collecting data for a large number of people or collecting multiple measurements for a smaller number of people. The results in this study will be useful to researchers who need to determine where to invest their effort when assessing water-related exposures and should help in evaluation of previously performed studies.

Estimating drinking-water ingestion and dermal contact with water in a French population of pregnant women: the EDDS cohort study

“…4,10 Estimates of Water Ingestion Tap water ingestion represented 71% of total water ingestion. With similar definition of water ingestion and data collection procedures relatively similar to ours, Forssé n et al 5 7 Proportion of tap water ingestion of EDDS women seemed to be comparable to that in English-speaking countries and lower than that in other Mediterranean countries, such as Italy or Spain.…”

“…5,7 One found, likewise, an appreciable correlation between early and mid-pregnancy ingestion (r ¼ 0.53 for tap water, 0.56 for bottled water and 0.40 for total water). 5 However, place of ingestion changed between second and third trimesters of pregnancy, as the result of work cessation. The only difference found in dermal water contact between the second and the third trimesters pertained to hand-washing.…”

“…They comprised questions chosen following an intensive review of the literature on water-use habits (Supplementary File 4) and exposure assessment questionnaire design. 18 The questionnaires had five sections: (i) socioeconomic data, 19 (ii) medical data, (iii) history of professional exposure, (iv) dermal water exposure, 4,5,[8][9][10] (v) drinking-water and bottled water ingestion frequency, 4-6,8-10 (vi) diet questions (rate of cans, fresh fruit and vegetable consumption), (vii) alcohol and tobacco consumption and (viii) cosmetics type and use frequency.…”

“…[1][2][3][4][5][6][7][8][9][10] Some studies have also assessed predictors of water-use habits during pregnancy. 4,5,9,10 Water ingestion is contingent on geographical and cultural factors; 1 so it is necessary to adapt data to the local context. Only one study has assessed water-use habits of French pregnant women.…”

“…11 This study assessed water ingestion at early pregnancy and described variations in consumption during pregnancy. 5 Furthermore, it assessed showering, bathing, swimming habits at 2-year follow up after birth, which could entail recall bias. 11 There are few birth cohorts that are monitored for studying water contaminants.…”