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DBPs analyzed were total trihalomethanes, the five most common haloacetic acids combined, and individual species. Associations were estimated for all NTDs combined and selected subtypes (spina bifida, anencephaly) with maternal periconceptional exposure to DBPs in public water systems and with average daily periconceptional ingestion of DBPs accounting for individual\u2010level consumption and filtration information. Mixed effects logistic regression models with maternal race\/ethnicity and educational attainment at delivery as fixed effects and study site as a random intercept were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 111 case and 649 control children were eligible for analyses. Adjusted odds ratios for maternal exposure to DBPs in public water systems ranged from 0.8\u20131.5 for all NTDs combined, 0.6\u20132.0 for spina bifida, and 0.7\u20131.9 for anencephaly; respective ranges for average daily maternal ingestion of DBPs were 0.7\u20131.1, 0.5\u20131.5, and 0.6\u20131.8. Several positive estimates (\u22651.2) were observed, but all confidence intervals included the null.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using community\u2010 and individual\u2010level data from a large, US, population\u2010based, case\u2013control study, we observed statistically nonsignificant associations between maternal periconceptional exposure to total and individual DBP species in drinking water and NTDs and subtypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2370","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T13:41:05Z","timestamp":1718718065000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Maternal periconceptional exposure to drinking water disinfection by\u2010products and neural tube defects in offspring"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2803-8030","authenticated-orcid":false,"given":"V.","family":"Kancherla","sequence":"first","affiliation":[{"name":"Department of Epidemiology Emory University Rollins School of Public Health  Atlanta Georgia USA"},{"name":"Department of Epidemiology, College of Public Health The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6510-9638","authenticated-orcid":false,"given":"A.","family":"Rhoads","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8633-966X","authenticated-orcid":false,"given":"K. M.","family":"Conway","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Suhl","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6765-4963","authenticated-orcid":false,"given":"P. H.","family":"Langlois","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics, and Environmental Science University of Texas School of Public Health \u2013 Austin Campus  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T.","family":"Hoyt","sequence":"additional","affiliation":[{"name":"Department of Health and Human Performance University of Houston  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7438-4914","authenticated-orcid":false,"given":"G. M.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. P.","family":"Evans","sequence":"additional","affiliation":[{"name":"Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities US Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4224-2692","authenticated-orcid":false,"given":"C. 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