title: Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort.
abstract: BACKGROUND
  Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects.
  
  
  METHODS
  We conducted a case-control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure (<10(th) , 10-50(th) , 50-90(th) , and >90(th) percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status.
  
  
  RESULTS
  We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]).
  
  
  CONCLUSIONS
  Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240-249, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Oak Ridge Institute for Science and Education at the U.S. Environmental Protection Agency, National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Rappazzo
authors.affiliation: Yale School of Public Health, Department of Biostatistics, New Haven, Connecticut.
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Warren
authors.affiliation: North Carolina Department of Health and Human Services, Raleigh, North Carolina.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Meyer
authors.affiliation: University of North Carolina Chapel Hill, Gillings School of Global Public Health, Department of Biostatistics, Chapel Hill, North Carolina.
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Alison P
authors.initials: AP
authors.lastname: Sanders
authors.affiliation: Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida.|Department of Statistics, Florida State University, Tallahassee, Florida.
authors.forename: Naomi C
authors.initials: NC
authors.lastname: Brownstein
authors.affiliation: National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Luben
mesh_terms: D000328:Adult; D000383:Agriculture; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects*; D009657:North Carolina / Q000453:epidemiology; D010575:Pesticides / Q000009:adverse effects*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D010575:Pesticides
keywords: GIS; agriculture; birth defects; congenital anomalies; pesticide exposure; residential