No connection between community water fluoridation, birth weight
A large, national cohort study found no evidence that community water fluoridation is associated with adverse birth outcomes. The research could offer reassurance about the safety of this long-standing public health intervention during pregnancy, according to a news article from The New York Times. The Centers for Disease Control and Prevention has long lauded community water fluoridation as one of the greatest public health achievements of the 20th century.
Concerns about fluoride exposure during pregnancy have increased in recent years, particularly in light of U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr.’s unfounded claims that fluoride is neurotoxic and carcinogenic, following observational studies suggesting possible links between fluoride and neurodevelopmental outcomes. Some prior studies also reported associations between maternal fluoride exposure and lower birth weight. However, many of those studies relied on cross-sectional designs that were vulnerable to confounding.
In the study, published in JAMA Network Open, investigators analyzed nearly 11.5 million singleton births across 677 U.S. counties between 1968 and 1988 — a period marked by the staggered adoption of community water fluoridation nationwide. Using detailed birth certificate data from the National Vital Statistics System's Natality Detail Files and fluoridation records from the CDC Fluoridation Census data, they examined whether prenatal exposure to fluoridated drinking water was associated with changes in infant birth weight or related outcomes. Experts cited in the article indicated that birth weight is often an early indicator of long-term health and educational attainment.
Across all analyses, the introduction of community water fluoridation was not associated with statistically significant changes in birth weight. The investigators noted that community water fluoridation also was not associated with gestational length or prematurity. The results were consistent across multiple sensitivity analyses, including models accounting for state-specific time trends and analyses restricted to counties with high fluoridation coverage to reduce potential exposure misclassification.
The investigators concluded that community water fluoridation did not predict adverse pregnancy outcomes measured via birth weight, thereby providing additional evidence of the safety of the practice. They emphasized the significance of using rigorous empirical studies to evaluate population-level interventions.
Read more: The New York Times
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