title: Stillbirth after occupational exposure to N-methyl-2-pyrrolidone. A case report and review of the literature.
abstract: N-methyl-2-pyrrolidone is a solvent that is increasingly used in a variety of industries, including petroleum refining, microelectronics, pesticide formulation, and veterinary medicine. Animal studies have demonstrated fetotoxic effects after maternal exposure to doses that have minimal to no adverse effect on the mothers. The fetotoxicity comprises resorption, stillbirth, and low birthweight and delayed ossification in surviving young. We report a human case of intrauterine growth retardation followed by fetal demise at 31 weeks gestation. The mother was a laboratory worker with no other apparent risk factors, who sustained occupational exposure to N-methyl-2-pyrrolidone throughout the first trimester of pregnancy. Laboratory work and solvent exposure have both previously been associated with adverse reproductive outcomes. Laboratories and other industries that use suspected reproductive toxins should have reproductive health policies in place that allow for decision-making based on toxicologic review, exposure assessment, and medical evaluation. These policies should allow for voluntary removal of prospective parents until environmental assessment and controls are instituted.
authors.affiliation: Occupational Health Program, Harvard School of Public Health, Boston, MA, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Solomon
authors.forename: E P
authors.initials: EP
authors.lastname: Morse
authors.forename: M J
authors.initials: MJ
authors.lastname: Garbo
authors.forename: D K
authors.initials: DK
authors.lastname: Milton
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000032:analysis; D002617:Chemical Industry; D004784:Environmental Monitoring; D005260:Female; D005313:Fetal Death / Q000139:chemically induced*; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D006801:Humans; D016273:Occupational Exposure; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011760:Pyrrolidinones / Q000009:adverse effects* / Q000032:analysis; D013723:Teratogens / Q000032:analysis; D016216:Ultrasonography, Prenatal
chemical_list: D000395:Air Pollutants, Occupational; D011760:Pyrrolidinones; D013723:Teratogens; C038678:N-methylpyrrolidone