Table 1.
Summary of cohort studies on the association between dioxin-related toxicants except Agent Orange and adverse pregnancy outcome
| First author,year (Country)Study period | Exposed | Unexposed | Exposed level | Exposure defini-tion/data sourceand measurement | Caseascertainment | Results |
|---|---|---|---|---|---|---|
| Rylander L,1995 (Sweden)1973-1991(24) | 65/1501Swedisheast coasts | 106/3553 Swed-ish west coasts | No specificvalues | Food exposure:eat locallycaught fish/national Swed-ish populationregister | Low birthweights (<2500g), exclusion ofmultiple birthsand infants withmajor malforma-tions by SwedishMedical BirthRegister | High con-sumption ofcontaminatedfish from theBaltic Seaassociatedincreased riskfor low birthweight |
| Rylander L,2000 (Sweden)1973-1993(25) | Swedish eastcoast high intakeof POC contami-nated fish fromthe Baltic Sea | Swedish westcoast | No specificvalues | Food exposure:sisters to thesefishermen.Sisters whowere, or hadbeen, marriedto a fishermanwere excluded/national Swed-ish populationregister | LBW, SGA,Stillbirths, Earlyneonatal deaths(<7 days age),malformations,by SwedishMedical BirthRegister | Exposure toPOC duringchildhood andadolescenceincreasedthe risk ofLBW, but notaffect SGA,Stillbirths andother malfor-mations |
| Small CM,2007 (US)1976-1997(26) | 529 women with1344 poten-tially exposedpregnancies in Michigan afterthe accidentalcontaminationof live stockscontaining PBBsand PCBs | All 861 womenreporting one ormore live birthsor spontaneousabortions inMichigan afterthe accidentalcontaminationof live stockscontaining PBBsand PCBs | PBB (ppb)Reference <1ppb; Exposed>1 ppb | Food exposure:food contamina-tion/exposures/based on therecords of Michi-gan Departmentof Public Health | Spontaneousabortions by self-reports | Results donot supportan associa-tion betweenexposure toPBBs or PCBsand risk ofspontaneousabortion |
| Tsukimori K,2008 (Japan)1968-2004(11) | 122 pregnanciesbetween 1968-1977, 88 preg-nancies between 1978-1987, 98pregnanciesbetween 1988-2003 | 204 pregnan-cies before 1968when Yusho oilincident hap-pened | No specificvalues | Food exposure:the exposurereferring tothe Yusho oilincident/expo-sures based onthe records of theYusho studyinggroup | Spontaneousabortion, pretermbirth, preg-nancy loss andinduced abortionby self-reports | Only in preg-nancy in thefirst 10 yearsafter exposure,the propor-tions of in-duced abortionand pretermdelivery weresignificantlyincreasedcompared withthe propor-tions in preg-nancy before1968 |
| Vinceti M 2008 (Italy) 2003-2006(27) | Person-years of 3796.64 women residing and 695.58 workersnear the municipal solid wasteincinerator | The remaining municipal population | 0-10×10-9 μg/m3 | Atmosphere exposure: according to mean annual atmospheric concentrations of, polychlorinated dibenzo-p-dioxin and dibenzofurans | Spontaneous abortion and birth defects by medical records | The study results provide little evidence of an excess risk of adverse pregnancy outcomes in women exposed to emissions from a modern municipal solid waste incinerator |
| Karmaus W, 1995 (Germany) 1987-1988(28) | 49 exposed pregnancies | 507 pregnancies unexposed | Median concentration was 0.5 pg/m3 | Indoor air exposure: women working in daycare centers treated with wood preservatives in the State of Hamburg and its vicinity/employer’s liability scheme | Induced abortion, miscarriage, stillbirth, birth length and birth weight from mother’s health card | The significant differences between exposed and unexposed were 175 g in birth weight and 2 cm in length |
| Fitzgerald EF,1989 (US) 1981-1984(29) | 482 persons who experience electrical transformer fire in Binghamton | The general population | TCDD average 3 ppm; TCDF: average 199 ppm | Air exposure: liability scheme exposure to the toxic contaminants of an electrical transformer fire/group exposure based on vital record | Spontaneous, fetal death, birth weight, congenital malformation from physician survey and hospital records | Infants with low birth weight or congenital malformations were similar to comparison population |
| Mastroiacovo P,1988 (Italy) 1977-1982(30) | 2900 infants born between 1978 and 1982 near the accident | 12391 infants born the same period not near the accident | A 192.8 μg/m2 B 3 μg/m2 R 0.9 μg/m2 | Air exposure: live in zones A, B, R surrounding the factory and direct exposure to the accident/health surveillance program | Malformation and birth defects by medical records | Failed to demonstrate any increased risk of birth defects associated with TCDD |
| Schnorr TM,*2001 (US)1950s-1960s (31) | 247 wives of 281 workers who were exposed to chemicals contaminated with TCDD; 632 pregnancies to workers’ wives | 215 wives of the referents; 707 pregnancies to referents’ wives | Serum TCDD level, exposed254 ppt;referent: 6 ppt; | Paternal exposure: Occupational exposures (chemical workers who were exposed to TCDD)/ exposures based on NIOSH’s records | Data on spontaneous abortion and sex ratio by (recognized clinical pregnancies) self-reports | Not find an association between paternal serum TCDD level and spontaneous abortion or sex ratio of offspring in this population |
*; Study was not used in meta-analysis because the objects in this study were fathers, POC; Persistent organochlorine compounds, PCB; Polychlorinated biphenyls, PBBs; Polybrominated biphenyls, NIOSH; National Institute for Occupational Safety and Health, TCDD; etrachlorodibenzo-p-dioxin, TCDF; Tetrachlorodibenzofuran, LBW; Low birth weight and SGA; Small for gestational age.