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Birth Defects Res. 2018 Dec 28. doi: 10.1002/bdr2.1448. [Epub ahead of print]

Maternal residential exposure to specific agricultural pesticide active ingredients and birth defects in a 2003-2005 North Carolina birth cohort.

Author information

Office of Research and Development, U.S. Environmental Research Triangle Park, Research Triangle Park, North Carolina.
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, NC, USA.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Department of Biostatistics, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina.
Department of Maternal and Child Health, Gillings School of Global Public Health University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida.
Department of Statistics, Florida State University, Tallahassee, Florida.



Previously we observed elevated odds ratios (ORs) for total pesticide exposure and 10 birth defects: three congenital heart defects and structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems. This analysis examines association of those defects with exposure to seven commonly applied pesticide active ingredients.


Cases were live-born singleton infants from the North Carolina Birth Defects Monitoring Program linked to birth records for 2003-2005; noncases served as controls (total n = 304,906). Pesticide active ingredient exposure was assigned using a previously constructed metric based on crops within 500 m of residence, dates of pregnancy, and likely chemical application dates for each pesticide-crop combination. ORs (95% CI) were estimated with logistic regression for categories of exposure compared to unexposed. Models were adjusted for maternal race/ethnicity, age at delivery, education, marital status, and smoking status.


Associations varied by birth defect and pesticide combinations. For example, hypospadias was positively associated with exposures to 2,4-D (OR50th to <90th percentile : 1.39 [1.18, 1.64]), mepiquat (OR50th to <90th percentile : 1.10 [0.90, 1.34]), paraquat (OR50th to <90th : 1.14 [0.93, 1.39]), and pendimethalin (OR50th to <90th : 1.21 [1.01, 1.44]), but not S-metolachlor (OR50th to <90th : 1.00 [0.81, 1.22]). Whereas atrial septal defects were positively associated with higher levels of exposure to glyphosate, cyhalothrin, S-metolachlor, mepiquat, and pendimethalin (ORs ranged from 1.22 to 1.35 for 50th to <90th exposures, and 1.72 to 2.09 for >90th exposures); associations with paraquat were null or inconsistent (OR 50th to <90th: 1.05 (0.87, 1.27).


Our results suggest differing patterns of association for birth defects with residential exposure to seven pesticide active ingredients in North Carolina.


agricultural pesticides; birth defects; environmental exposure


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