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Apart from an increase in dental fluorosis, recent reviews of water fluoridation found little evidence of adverse effects.1,2 Several studies looked at congenital abnormalities, two of which found a negative effect of water fluoridation, although overall the evidence was inconclusive. The reviews also raised the issue of the paucity of published data on congenital abnormalities, the possibility of publication bias, and the need for more data; and the age of existing research, the poor quality, and the failure to control for confounding factors.
METHODS AND RESULTS
Our study was based on residence within the boundaries of the former Northern health region in the north east of England, with a population of 3 million and about 35 000 deliveries per year. Artificially fluoridated and non-fluoridated areas were chosen with similar populations, sociodemographic characteristics, termination rates, and fluoride supplement regimens. Cases were identified from two population based registers, the Northern Perinatal Mortality Survey (PMS) and the Northern Congenital Abnormality Survey (NorCAS).3
All stillbirths occurring between 1 …