Association Between Maternal Exposure to Elevated Concentration of Trihalomethanes in Drinking Water During Pregnancy and Adverse Birth Outcomes in Queensland, Australia: A Population-Based Data Linkage Study

Md. Mehedi Hasan; M. Mamun Huda; Edmund Wedam Kanmiki; Phil Choi; Yaqoot Fatima; Greg Jackson; Kevin Thomas; Ricardo Soares-Magalhaes; Frances M. Boyle; Peter Sly; Leonie Callaway; Tuhin Biswas; Abdullah A. Mamun

doi:10.1007/s12403-026-00816-6

Back

Association Between Maternal Exposure to Elevated Concentration of Trihalomethanes in Drinking Water During Pregnancy and Adverse Birth Outcomes in Queensland, Australia: A Population-Based Data Linkage Study

Journal article

Open access

Peer reviewed

PUBLISHED

Association Between Maternal Exposure to Elevated Concentration of Trihalomethanes in Drinking Water During Pregnancy and Adverse Birth Outcomes in Queensland, Australia: A Population-Based Data Linkage Study

Md. Mehedi Hasan, M. Mamun Huda, Edmund Wedam Kanmiki, Phil Choi, Yaqoot Fatima, Greg Jackson, Kevin Thomas, Ricardo Soares-Magalhaes, Frances M. Boyle, Peter Sly, …

Exposure and Health, Vol.18(5), pp.1-13

2026

DOI: https://doi.org/10.1007/s12403-026-00816-6

Files and links (1)

pdf

Association Between Maternal Exposure to Elevated Concentration of Trihalomethanes in Drinking Water During Pregnancy and Adverse Birth Outcomes in Queensland, Australia: A Population-Based Data Linkage Study1.02 MBDownload View

Published Version Open Access CC BY V4.0

Abstract

Disinfection by-products

Trihalomethanes

Adverse birth outcomes

Preterm birth

Low birthweight

Small-for-gestational age

Epidemiological evidence between exposure to trihalomethanes (THMs) and adverse birth outcomes remains inconsistent. We examined the associations between maternal exposure to elevated THM concentration in drinking water during pregnancy and adverse birth outcomes, including preterm birth (PTB), low birthweight (LBW), and small-for-gestational age (SGA). We analysed population-based data of 134,966 singleton livebirths recorded across 25 local government areas (LGAs) between 2009 and 2020 using the Queensland Perinatal Data Collection, water quality monitoring data, meteorological data, and Australian Bureau of Statistics records. Maternal exposure to elevated THM exceeding thresholds of ≥ 250, ≥100, ≥ 80, and ≥ 70 µg/L was defined using monthly total THM concentrations. We applied Generalized Estimating Equation models to examine exposure-outcome associations. Overall, 6.8% of babies were born preterm, 5.0% LBW, and 9.2% SGA, with marked geographic disparities across background characteristics. Temporal analyses revealed an increase in LBW prevalence from 3.7% to 5.2% (average annual rate of change 1.6%). Lower odds of SGA were associated with maternal exposure to elevated THM concentrations at ≥ 100 µg/L (Adjusted Odds Ratio, AOR = 0.91, 95% CI [0.88–0.95]) and at ≥ 80 µg/L (0.93, [0.88–0.97]). Across individual disinfection by-products, bromodichloromethane exceedance at ≥ 250 µg/L was associated with higher odds of PTB (1.07, [1.01,1.13]), and bromoform exceedance at ≥ 70 µg/L was associated with higher odds of LBW (1.22, [1.01,1.48]). The disparities in adverse birth outcomes warrant identifying regional factors to inform targeted health interventions. Continued research employing improved study design and more accurate exposure measurement is needed to synthesize conclusive evidence and clarify causal relationships to inform decision-making.

Details

Title: Association Between Maternal Exposure to Elevated Concentration of Trihalomethanes in Drinking Water During Pregnancy and Adverse Birth Outcomes in Queensland, Australia: A Population-Based Data Linkage Study
Authors: Md. Mehedi Hasan (Corresponding Author) - The University of Queensland
M. Mamun Huda - Charles Sturt University
Edmund Wedam Kanmiki - The University of Queensland
Phil Choi - Queensland Health
Yaqoot Fatima - University of the Sunshine Coast
Greg Jackson - The University of Queensland
Kevin Thomas - The University of Queensland
Ricardo Soares-Magalhaes - The University of Queensland
Frances M. Boyle - The University of Queensland
Peter Sly - The University of Queensland
Leonie Callaway - Royal Brisbane and Women's Hospital
Tuhin Biswas - Asian University for Women
Abdullah A. Mamun - The University of Queensland
Publication details: Exposure and Health, Vol.18(5), pp.1-13
Publisher: Springer Dordrecht
Date published: 2026
DOI: 10.1007/s12403-026-00816-6
ISSN: 2451-9685
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: All the data has been presented in the manuscript.
Grants: ARC Centre of Excellence for Children and Families over the Life Course, CE200100025, Australian Research Council (Australia, Canberra) - ARC
Exposure to Trihalomethanes in pregnancy and birth outcomes in Queensland: integrated data analysis and case studies for better policy and health outcomes, 1198495, National Health and Medical Research Council (Australia, Canberra) - NHMRC
Organisation Unit: Indigenous and Transcultural Research Centre; Thompson Institute
Language: English
Record Identifier: 991272091502621
Output Type: Journal article

Metrics

1 Record Views