Risk of stillbirth from occupational and residential exposures

Lisa M. Pastore, Irva Hertz-Picciotto, James J. Beaumont

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Objectives - To analyse the risk of stillbirth from 12 residential and occupational maternal exposures during pregnancy. Methods - Stillbirths and neonatal deaths in 1984 within 24 hours of birth from 10 California counties were identified from death certificates. Controls were randomly selected from Live births born in 1984 and frequency matched to cases by maternal age and county. Data sources included vital statistics and a self administered postal questionnaire. Logistic regression and proportional modelling were performed; the proportional hazards considered the truncated opportunity for exposure among cases. Special focus was given 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 months of gestation was positively associated with stillbirths due to congenital anomalies (odds ratio (OR) 2.4, 95% confidence interval (95% CI) 1.0 to 5.9), and during the first and second trimesters with stillbirths 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, and 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 modest inverse association with stillbirths (RR 0.7, 95% CI 0.6, 0.9). Home pesticide exposure was positively associated with stillbirths due to congenital anomalies (OR 1.7, 95% CI 1.0 to 2.9). Conclusions - Occupational 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 analysis of specific causes of death and use of time specific exposure windows.

Original languageEnglish (US)
Pages (from-to)511-518
Number of pages8
JournalOccupational and Environmental Medicine
Issue number7
StatePublished - 1997
Externally publishedYes


  • Epidemiology
  • Fetal death
  • Pesticides
  • Survival analysis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Environmental Science(all)


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