AGENT ORANGE AND THE RISK OF GESTATIONAL TROPHOBLASTIC DISEASE IN VIETNAM

There have been claims of an increased risk for gestational trophoblas tic disease (i.e., hydatidiform mole and choriocarcinoma) in Vietnam s ince the period of Agent Orange sprayings. In 1990, we conducted a cas e-control study in Ho Chi Minh City to investigate risk factors for ge stational trophoblastic disease in Vietnam. Eighty-seven married women , all of whom had a recent pathologic diagnosis of gestational trophob lastic disease, identified in the Obstetrical and Gynecological Hospit al, were included in the study. Eighty-seven married women who were ad mitted mainly in the surgery departments of the same hospital were the controls, and they were matched to cases for age and area of residenc e. Odds ratios (ORs), adjusted for matching variables and other potent ial confounders, were estimated with unconditional logistic regression . A statistically significant trend in risk was observed with previous live births (p = .01). Cases were found to eat less meat per wk (OR = 0.4, 95% confidence interval [95% CI] = 0.2-0.9 for greater than or e qual to five meat dishes) and to own fewer consumer goods than control s. An increase in risk was associated with the breeding of pigs (OR = 5.7, 95% CI = 1.2-27.6 for raising three or more pigs). A cumulative A gent Orange exposure index was constructed, using the patient's comple te residence history. No significant difference was found between case s and controls for this index (OR = 0.7, 95% Ci = 0.2-1.8 for high-exp osure category), nor was such a difference noted for the agricultural use of pesticides.