Agricultural pesticide exposure and perinatal mortality in central Sudan
Taha, T.E.; Gray, R.H.
Bulletin of the World Health Organization 71(3-4): 317-321
1993
ISSN/ISBN: 0042-9686 PMID: 8324850 Document Number: 328192
Between March 1989 and June 1990, hospital and community based studies compared perinatal deaths with liveborn, normal birth weight infants who survived the neonatal period to examine the association between perinatal mortality and exposure to agricultural pesticides in the largest and oldest agricultural project in the Sudan--the Gezira Scheme. The main referral hospitals were in Wad Medani and Sennar. Data were gathered on all midwife assisted births at the 6 health centers between these 2 cities in central Sudan. The hospital, case control study included 197 perinatal deaths and 812 liveborn controls. The community based case control study included 36 perinatal deaths and 1505 liveborn controls. The researchers adjusted for any potential cofounders. Exposure to any pesticide spraying significantly increased the risk of stillbirth in the hospital population and of perinatal death in the community population (odds ratios [ORs] = 1.9 and 2.7 respectively). Pesticide spraying most significantly affected perinatal deaths in women engaged in farming (OR of fetal death = 3.6). The OR for nonfarmers indicated increased risk of perinatal death, but it was not significant (1.6). Pesticide exposure accounted for 15.7% of community perinatal deaths and 22.6% of hospital stillbirths. It attributed more greatly to perinatal deaths of women farmers than it did to women nonfarmers (34.5 vs. 10.7%). The association between exposure to pesticides and the occurrence of perinatal deaths was consistent in both the hospital and community studies as well as with findings of studies from India and Colombia. This association and the high attributable risks suggest that pesticide exposure causes perinatal mortality. These findings indicate the needs for pregnant women to be protected from exposure to pesticides and for awareness about safer use of chemicals to be increased.