title: Maternal serum dioxin levels and birth outcomes in women of Seveso, Italy.
abstract: 2,3,7,8-Tetrachlorodibenzo-(italic)para(/italic)-dioxin (TCDD), a ubiquitous environmental contaminant, is associated with increased fetal loss and reduced birth weight in animal studies. In 1976, an explosion at a trichlorophenol plant near Seveso, Italy, resulted in the highest TCDD exposure known in human residential populations. In 1996, we initiated the Seveso Women's Health Study, a retrospective cohort study of women who resided in the most contaminated areas, zones A and B. We examined the relation of pregnancy outcome in 510 women (888 total pregnancies) to maternal TCDD levels measured in serum collected shortly after the explosion. Ninety-seven pregnancies (10.9%) ended as spontaneous abortions (SABs). There was no association of log(subscript)10(/subscript) TCDD with SAB [adjusted odds ratio (OR) = 0.8; 95% confidence interval (CI), 0.6-1.2], with birth weight (adjusted beta = -4 g; 95% CI, -68 to 60), or with births that were small for gestational age (SGA) (adjusted OR = 1.2; 95% CI, 0.8-1.8). However, associations with birth weight (adjusted beta = -92 g; 95% CI, -204 to 19) and with SGA (adjusted OR = 1.4; 95% CI, 0.6-2.9) were stronger for pregnancies within the first 8 years after exposure. TCDD was associated with a 1.0-1.3 day nonsignificant adjusted decrease in gestational age and a 20-50% nonsignificant increase in the odds of preterm delivery. It remains possible that the effects of TCDD on birth outcomes are yet to be observed, because the most heavily exposed women in Seveso were the youngest and the least likely to have yet had a pregnancy.
authors.affiliation: School of Public Health, University of California at Berkeley, Berkeley, California 94720-7360, USA. eskenazi@uclink4.berkeley.edu
authors.forename: Brenda
authors.initials: B
authors.lastname: Eskenazi
authors.forename: Paolo
authors.initials: P
authors.lastname: Mocarelli
authors.forename: Marcella
authors.initials: M
authors.lastname: Warner
authors.forename: Wan-Ying
authors.initials: WY
authors.lastname: Chee
authors.forename: Pier Mario
authors.initials: PM
authors.lastname: Gerthoux
authors.forename: Steven
authors.initials: S
authors.lastname: Samuels
authors.forename: Larry L
authors.initials: LL
authors.lastname: Needham
authors.forename: Donald G
authors.initials: DG
authors.lastname: Patterson
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced; D000328:Adult; D002617:Chemical Industry; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005107:Explosions; D005260:Female; D006801:Humans; D007558:Italy; D018811:Maternal Exposure / Q000009:adverse effects*; D000072317:Polychlorinated Dibenzodioxins / Q000097:blood* / Q000506:poisoning; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects
chemical_list: D000072317:Polychlorinated Dibenzodioxins