RISK OF STILLBIRTH FROM OCCUPATIONAL AND RESIDENTIAL EXPOSURES

Objectives-To analyse the risk of stillbirth from 12 residential and o ccupational maternal exposures during pregnancy. Methods-Stillbirths a nd neonatal deaths in 1984 within 24 hours of birth from 10 California counties were identified from death certificates. Controls were rando mly selected from live births born in 1984 and frequency matched to ca ses by maternal age and county. Data sources included vital statistics and a self administered postal questionnaire. regression and proporti onal modelling were performed; the proportional hazards considered the truncated opportunity for exposure among cases. Special focus was giv en to two cause of death groups: congenital anomalies (12% of deaths) and complications of the placenta, cord, and membranes (37% of deaths) . Results-Occupational exposure to pesticides during the first two mon ths of gestation was positively associated with stillbirths due to con genital anomalies (odds ratio (OR) 2.4, 95% confidence interval (95% C I) 1.0 to 5.9), and during the first and second trimesters with stillb irths due to all causes of death (risk ratios (RR) 1.3-1.4, 95% CI 1.0 to 1.7) and stillbirths due to complications of the placenta, cord, a nd membranes (RR 1.6-1.7, 95% CI 1.1 to 2.3). Occupational exposure to video display terminals in the third trimester was found to have a mo dest inverse association with stillbirths (RR 0.7, 95% CI 0.6, 0.9). H ome pesticide exposure was positively associated with stillbirths due to congenital anomalies (OR 1.7, 95% CI 1.0 to 2.9). Conclusions-Occup ational exposure to pesticides, especially during early pregnancy, had a clear positive association with stillbirths regardless of cause of death. Methodologically, this study of stillbirths is unique in its an alysis of specific causes of death and use of time specific exposure w indows.