Ueker Marly Eliane, Silva Vivianne Monteiro, Moi Gisele Pedroso, Pignati Wanderley Antonio, Mattos Ines Echenique, Silva Ageo Mário Cândido
Institute of Collective Health, Federal University of Mato Grosso (UFMT), Av. Fernando Corrêa, 2367. CCBSIII Block, 2nd floor. Boa Esperança, 78060-900, Cuiabá, MT, Brazil.
University Center of Várzea Grande (UNIVAG/MT), Várzea Grande, Brazil.
BMC Pediatr. 2016 Aug 12;16(1):125. doi: 10.1186/s12887-016-0667-x.
Most fetal defects are associated with genetic and environmental causes, among them, exposure of pregnant women to intensive pesticide use. Agribusiness is the economic basis of the state of Mato Grosso, the largest consumer of pesticides of all Brazilian states. The objective of this study was to investigate the association between past parental exposure to pesticides and the occurrence of congenital malformations in children in Mato Grosso, Brazil.
This hospital-based case-control study was conducted in Cuiabá, the capital of Mato Grosso, from March to October 2011. Data was collected in all public, private, and health plan referral hospitals that provide care for pregnant women in the state of Mato Grosso and were situated in Cuiabá. Cases were children under 5 years of age with congenital malformations classified in Chapter XVIII of the International Classification of Diseases-10 and controls were children within the same age range, without congenital malformations, treated at the same hospitals. Malformation-related data was obtained from the patients' medical records. Socioeconomic data and information about parental exposure to pesticides were obtained in an interview with the mother using a standardized questionnaire. We conducted multivariate logistic regression to assess the relation between parent report of past pesticide use and congenital malformations. We also assessed effect modification to verify whether low maternal education level modified the association between exposure and our outcome.
We observed positive effect modification of the association of paternal past exposure to pesticide and congenital malformation in the offspring by maternal education for mothers with low educational level (OR = 8.40, 95 % CI 2.17-32.52), father's work related to farming (OR = 4.65, 95 % CI 1.03-20.98) and paternal past exposure to pesticides (OR = 4.15, 95 % CI 1.24-13.66).
These findings provide further evidence that paternal exposure to pesticides, especially when associated with a low maternal education level, may be related to higher rates of fetal malformation in Mato Grosso, Brazil.
大多数胎儿缺陷与遗传和环境因素有关，其中包括孕妇接触大量使用的农药。农业综合企业是马托格罗索州的经济基础，该州是巴西所有州中农药消费量最大的。本研究的目的是调查巴西马托格罗索州父母过去接触农药与儿童先天性畸形发生之间的关联。
这项基于医院的病例对照研究于2011年3月至10月在马托格罗索州首府库亚巴进行。数据收集于马托格罗索州所有为孕妇提供护理且位于库亚巴的公立、私立和健康计划转诊医院。病例为5岁以下患有国际疾病分类第10版第十八章中分类的先天性畸形的儿童，对照为同一年龄范围内、在同一家医院接受治疗且无先天性畸形的儿童。与畸形相关的数据从患者的病历中获取。社会经济数据以及有关父母接触农药的信息通过使用标准化问卷对母亲进行访谈获得。我们进行了多因素逻辑回归分析，以评估父母报告的过去农药使用情况与先天性畸形之间的关系。我们还评估了效应修正，以验证低母亲教育水平是否改变了暴露与我们的结局之间的关联。
我们观察到，对于教育水平低的母亲，母亲教育对父亲过去接触农药与后代先天性畸形之间的关联具有正向效应修正作用（比值比= 8.40，95%置信区间2.17 - 32.52）、父亲与农业相关的工作（比值比= 4.65，95%置信区间1.03 - 20.98）以及父亲过去接触农药（比值比= 4.15，95%置信区间1.24 - 13.66）。
这些发现提供了进一步的证据，表明父亲接触农药，尤其是与低母亲教育水平相关联时，可能与巴西马托格罗索州较高的胎儿畸形率有关。
