This population-based U.S. study investigated the association between major musculoskeletal malformations and periconceptional maternal occupational pesticide exposure for a wide range of occupations. We conducted a multi-site case–control analysis using data from the National Birth Defects Prevention Study among employed women with due dates from October 1, 1997 through December 31, 2002. Cases included 871 live-born, stillborn, or electively terminated fetuses with isolated craniosynostosis, gastroschisis, diaphragmatic hernia, or transverse limb deficiencies. Controls included 2857 live-born infants without major malformations. Using self-reported maternal occupational information, an industrial hygienist used a job-exposure matrix and expert opinion to evaluate the potential for exposure to insecticides, herbicides or fungicides for each job held during one month pre-conception through three months post-conception. Exposures analyzed included any exposure (yes/no) to pesticides, to insecticides only, to both insecticides and herbicides (I + H) and to insecticides, herbicides and fungicides (I + H + F). We used logistic regression to evaluate the association between exposures and defects, controlling for infant and maternal risk factors. Occupational exposure to I + H + F was associated with gastroschisis among infants of women aged 20 years or older (adjusted odds ratio [aOR] = 1.88; 95% confidence interval [CI]: 1.16–3.05), but not for women under age 20 (aOR = 0.48; 95% CI: 0.20–1.16). We found no significant associations for the other defects. Additional research is needed to validate these findings in a separate population.

这项基于人群的美国研究调查了主要肌肉骨骼畸形与围孕期孕产妇职业性农药暴露之间的关联，范围广泛。我们使用全国出生缺陷预防研究的数据对预产期为 1997 年 10 月 1 日至 2002 年 12 月 31 日的受雇妇女进行了多地点病例对照分析。病例包括 871 例活产、死产或选择性终止胎儿孤立性颅缝早闭、腹裂、膈疝或横断肢缺陷。对照组包括 2857 名没有严重畸形的活产婴儿。使用自我报告的产妇职业信息，一名工业卫生员使用工作暴露矩阵和专家意见来评估接触杀虫剂的可能性，在受孕前一个月至受孕后三个月期间进行的每项工作的除草剂或杀菌剂。所分析的暴露包括对杀虫剂、仅对杀虫剂、对杀虫剂和除草剂 (I + H) 以及对杀虫剂、除草剂和杀真菌剂 (I + H + F) 的任何暴露（是/否）。我们使用逻辑回归来评估暴露和缺陷之间的关联，控制婴儿和母亲的危险因素。职业暴露于 I + H + F 与 20 岁或以上女性婴儿的腹裂相关（调整后的优势比 [aOR] = 1.88；95% 置信区间 [CI]：1.16-3.05），但与年龄不足的女性无关20（aOR = 0.48；95% CI：0.20–1.16）。我们没有发现其他缺陷的显着关联。需要额外的研究来在单独的人群中验证这些发现。