title: Exposure to pistachio pesticides and stillbirth: a case-control study.
abstract: OBJECTIVE
  Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers.
  
  
  METHODS
  This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother's residence and a pistachio garden or involvement in agricultural activities.
  
  
  CONCLUSIONS
  The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.
authors.affiliation: Department of Epidemiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Razi
authors.affiliation: Department of Social Medicine and Environmental Research Center, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Rezaeian
authors.affiliation: Department of Operation Room, School of Paramedical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Fatemeh Ghani
authors.initials: FG
authors.lastname: Dehkordi
authors.affiliation: Department of Gynecology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Azita
authors.initials: A
authors.lastname: Manshoori
authors.affiliation: Department of Epidemiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Goujani
authors.affiliation: Social Determinants of Health Research Center, Social Medicine Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Vazirinejad
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D010575:Pesticides / Q000506:poisoning*; D027927:Pistacia; D011247:Pregnancy; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D010575:Pesticides
keywords: Case-control studies; Iran; Pesticides; Pregnancy; Stillbirth