Medina-Carrilo L, Rivas-Solis F, Fernández-Argüelles R
Instituto Mexicano del Seguro Social, Tepic, Nayarit.
Ginecol Obstet Mex. 2002 Nov;70:538-44.
To measure the association between the use of pesticides and congenital malformations.
We studied 279 newborn from mothers living in rural area of Nayarit, a state in the northwest region of México. Cases (n = 93) were defined as newborn with central nervous, face, genital, hip, foot or finger congenital malformations. Controls (n = 186) were newborns without any malformation. We considered as exposure any type of contact with any of the agrochemicals used as pesticides. We evaluated other risk factors such as medical drugs, fever, exposure to radiation, obstetric and family factors, as confoundings.
We registered 22 genital malformations, 20 from hip, 19 from the central nervous system, 18 from extremities and 14 cleft-lip or palate. Exposed mothers had high risk of having a malformed child (OR = 3.5, CI95% 2.05-6.34, p < 0.05). Risk was higher if the mother had occupational exposure to pesticides (OR = 6.33, CI95% 2.95-13.7, p < 0.0001) and in mothers living near areas under pesticides treatment (OR = 3.47, CI95% 1.91-6.33, p < 0.0001). Among obstetric factors, abortion and early delivery (OR = 15.05, CI95% 1.82-124.30, p < 0.01) were significant.
This study shows association between exposure to pesticides and congenital malformation. This is a public health problem in Nayarit state and in other rural areas with similar exposure to pesticides.
测量农药使用与先天性畸形之间的关联。
我们研究了来自墨西哥西北部纳亚里特州农村地区母亲的279名新生儿。病例（n = 93）定义为患有中枢神经、面部、生殖器、髋关节、足部或手指先天性畸形的新生儿。对照组（n = 186）为无任何畸形的新生儿。我们将与任何用作农药的农用化学品的任何形式接触视为暴露。我们评估了其他风险因素，如药物、发热、辐射暴露、产科和家庭因素，作为混杂因素。
我们记录了22例生殖器畸形、20例髋关节畸形、19例中枢神经系统畸形、18例肢体畸形和14例唇腭裂。暴露的母亲生出畸形孩子的风险较高（OR = 3.5，95%CI 2.05 - 6.34，p < 0.05）。如果母亲职业性接触农药，风险更高（OR = 6.33，95%CI 2.95 - 13.7，p < 0.0001），且居住在农药处理区域附近的母亲风险也更高（OR = 3.47，95%CI 1.91 - 6.33，p < 0.0001）。在产科因素中，流产和早产（OR = 15.05，95%CI 1.82 - 124.30，p < 0.01）具有显著性。
本研究表明农药暴露与先天性畸形之间存在关联。这是纳亚里特州以及其他农药暴露情况相似的农村地区的一个公共卫生问题。
