title: Influence of environmental contamination on pregnancy outcomes.
abstract: This study aims to compare pregnancy outcomes in four contaminated areas to those observed in a non-contaminated area of similar socioeconomic status. A cross-sectional study was carried out. A structured and pre-tested questionnaire was administered to population-based samples of 788-920 families in each of the five studied areas. The exposure assessment used was an ecological measure. Using logistic regression, odds of several pregnancies outcomes (pregnancy occurrence, miscarriage, stillbirth, prematurity, low birth weight, congenital malformation, and multiple births) were estimated after adjustment for potential confounders such as socioeconomic, demographic, and substance abuse factors. We adopted a statistical significance level of 5 %. In three of the four exposed areas, pregnancy occurrence was reduced in comparison to the control area (Area 2, odds ratio (OR) = 0.68, 95 % CI = 0.54-0.86; Area 3, OR = 0.76, 95 % CI = 0.60-0.97; Area 4, OR = 0.71, 95 % CI = 0.56-0.90). Also, a significantly increased odds of miscarriage for living in Area 3 (OR = 1.83, 95 % CI = 1.07-3.12) was found. The other pregnancy outcomes were not significantly elevated in the exposed areas. In conclusion, this study shows evidence of reduced pregnancy occurrence and increased miscarriage occurrence in some of the contaminated areas, compared to the control area.
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, Av. Dr. Arnaldo, 455 s1304 Cerqueira César, CEP: 01246-903, São Paulo, SP, Brazil. marianatguimaraes@yahoo.com.br.|School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715 s.204, Pacaembu, CEP: 01246-904, São Paulo, SP, Brazil. marianatguimaraes@yahoo.com.br.
authors.forename: Mariana Tavares
authors.initials: MT
authors.lastname: Guimarães
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Av. Conselheiro Nébias, 300 Vila Matias, CEP: 11015-002, Santos, SP, Brazil.
authors.forename: Michele Granato
authors.initials: MG
authors.lastname: Cunha
authors.affiliation: Institute of Biophysics Carlos Chagas Filho, Laboratory of Radioisotopes Eduardo Penna Franca, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, CCS, CEP: 21941-902, Rio de Janeiro, RJ, Brazil.
authors.forename: Daniele Pena
authors.initials: DP
authors.lastname: Carvalho
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, Av. Dr. Arnaldo, 455 s1304 Cerqueira César, CEP: 01246-903, São Paulo, SP, Brazil.
authors.forename: Tatyana Sampaio
authors.initials: TS
authors.lastname: Ribeiro
authors.affiliation: Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Av. Conselheiro Nébias, 300 Vila Matias, CEP: 11015-002, Santos, SP, Brazil.
authors.forename: Lourdes Conceição
authors.initials: LC
authors.lastname: Martins
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, Av. Dr. Arnaldo, 455 s1304 Cerqueira César, CEP: 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Av. Conselheiro Nébias, 300 Vila Matias, CEP: 11015-002, Santos, SP, Brazil.
authors.forename: Alfésio Luís Ferreira
authors.initials: AL
authors.lastname: Braga
authors.affiliation: Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Faculty of Medical Sciences, Av. Dr. Arnaldo, 455 s1304 Cerqueira César, CEP: 01246-903, São Paulo, SP, Brazil.|Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Catholic University of Santos, Av. Conselheiro Nébias, 300 Vila Matias, CEP: 11015-002, Santos, SP, Brazil.
authors.forename: Luiz Alberto Amador
authors.initials: LA
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004785:Environmental Pollutants / Q000633:toxicity*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants
keywords: Congenital malformation; Environmental pollution; Low birth weight; Miscarriage; Multiple births; Pregnancy; Preterm birth; Stillbirth