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Kim, Jihye; Swartz, Michael D.; Langlois, Peter H.; Romitti, Paul A.; Weyer, Peter J.; Mitchell, Laura E.; Luben, Thomas J.; Ramakrishnan, Anushuya; Malik, Sadia; & Lupo, Philip J., et al. (2017). Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring. International Journal of Environmental Research and Public Health, 14(8), 889. PMCID: PMC5580593


Our objective was to examine the relationship between estimated maternal exposure to pesticides in public drinking water and the risk of congenital heart defects (CHD). We used mixed-effects logistic regression to analyze data from 18,291 nonsyndromic cases with heart defects from the Texas Birth Defects Registry and 4414 randomly-selected controls delivered in Texas from 1999 through 2005. Water district-level pesticide exposure was estimated by linking each maternal residential address to the corresponding public water supply district's measured atrazine levels. We repeated analyses among independent subjects from the National Birth Defects Prevention Study (NBDPS) (1620 nonsyndromic cases with heart defects and 1335 controls delivered from 1999 through 2005). No positive associations were observed between high versus low atrazine level and eight CHD subtypes or all included heart defects combined. These findings should be interpreted with caution, in light of potential misclassification and relatively large proportions of subjects with missing atrazine data. Thus, more consistent and complete monitoring and reporting of drinking water contaminants will aid in better understanding the relationships between pesticide water contaminants and birth defects.


Reference Type

Journal Article

Year Published


Journal Title

International Journal of Environmental Research and Public Health


Kim, Jihye
Swartz, Michael D.
Langlois, Peter H.
Romitti, Paul A.
Weyer, Peter J.
Mitchell, Laura E.
Luben, Thomas J.
Ramakrishnan, Anushuya
Malik, Sadia
Lupo, Philip J.
Feldkamp, Marcia L.
Meyer, Robert E.
Winston, Jennifer Jane
Reefhuis, Jennita
Blossom, Sarah J.
Bell, Erin M.
Agopian, A. J.