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Brenda Eskenazi,¹ Paolo Mocarelli,² Marcella Warner,¹ Wan-Ying Chee,¹ Pier Mario Gerthoux,² Steven Samuels,^1,3 Larry L. Needham,⁴ and Donald G. Patterson, Jr.⁴

¹School of Public Health, University of California at Berkeley, Berkeley, California, USA; ²Department of Laboratory Medicine, University of Milano-Bicocca, School of Medicine, Hospital of Desio, Desio-Milano, Italy; ³Division of Occupational/Environmental Medicine and Epidemiology, University of California at Davis, Davis, California, USA; ⁴Division of Environmental Health Laboratory Science, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Abstract

2,3,7,8-Tetrachlorodibenzo-para-dioxin (TCDD) , a ubiquitous environmental contaminant, is associated with increased fetal loss and reduced birth weight in animal studies. In 1976, an explosion at a trichlorophenol plant near Seveso, Italy, resulted in the highest TCDD exposure known in human residential populations. In 1996, we initiated the Seveso Women's Health Study, a retrospective cohort study of women who resided in the most contaminated areas, zones A and B. We examined the relation of pregnancy outcome in 510 women (888 total pregnancies) to maternal TCDD levels measured in serum collected shortly after the explosion. Ninety-seven pregnancies (10.9%) ended as spontaneous abortions (SABs) . There was no association of log₁₀ TCDD with SAB [adjusted odds ratio (OR) = 0.8 ; 95% confidence interval (CI) , 0.6-1.2], with birth weight (adjusted beta = -4 g ; 95% CI, -68 to 60) , or with births that were small for gestational age (SGA) (adjusted OR = 1.2 ; 95% CI, 0.8-1.8) . However, associations with birth weight (adjusted beta = -92 g ; 95% CI, -204 to 19) and with SGA (adjusted OR = 1.4 ; 95% CI, 0.6-2.9) were stronger for pregnancies within the first 8 years after exposure. TCDD was associated with a 1.0-1.3 day nonsignificant adjusted decrease in gestational age and a 20-50% nonsignificant increase in the odds of preterm delivery. It remains possible that the effects of TCDD on birth outcomes are yet to be observed, because the most heavily exposed women in Seveso were the youngest and the least likely to have yet had a pregnancy. Key words: birth weight, dioxin, environmental exposures, epidemiology, small for gestational age, spontaneous abortion. Environ Health Perspect 111:947-953 (2003) .