Maternal Residential Atrazine Exposure and Risk for Choanal Atresia and Stenosis in Offspring

Abstract

Objective To assess the relationship between estimated residential maternal exposure to atrazine during pregnancy and risk for choanal atresia or stenosis in offspring. Study Design Data for 280 nonsyndromic cases and randomly selected, population-based controls delivered during 1999 to 2008 were obtained from the Texas Birth Defects Registry. County-level estimates of atrazine levels obtained from the United States Geological Survey were assigned to cases and controls based on maternal county of residence at delivery. Unconditional logistic regression was used to assess the relationship between maternal residential atrazine exposure and risk for choanal atresia or stenosis in offspring. Results Compared to offspring of mothers with low levels of estimated residential atrazine exposure, those with high levels had nearly a two-fold increase in risk for choanal atresia or stenosis (adjusted odds ratio: 1.79, 95% confidence interval: 1.17–2.74). A significant linear trend was also observed with increasing levels of atrazine exposure (adjusted P = 0.002). Conclusions A link between maternal exposure to endocrine disruptors, such as atrazine, and choanal atresia risk is plausible based on previous findings. Our results further support this hypothesis.

Atrazine and Pregnancy Outcomes: A Systematic Review of Epidemiologic Evidence

“…The authors justified their maternal age analysis based on the higher incidence of gastroschisis in infants born to younger women and the possibility that an ATR-associated risk would be more difficult to detect against a higher age-related background. In the another study conducted by the same group and using the same methods (Agopian et al, 2013a), there was a statistically significant positive relationship between choanal atresia and ATR exposure category when the highest level of exposure (>90th percentile) was compared with the first quartile (OR = 1.79; 95% CI, 1.17–2.74) with evidence of a linear trend ( p = 0.002). The third case–control study in this series (Agopian et al, 2013c) focused on male genital abnormalities.…”

“…Not all studies were entirely independent. The three Canadian studies used data from the Ontario Farm Family Health Study (Savitz et al, 1997; Arbuckle et al, 2001; Weselak et al, 2008), two French studies (Limousi et al, 2013; Migeot et al, 2013) were based on the same data from the district of Deux-Sèvres in the Poitou-Charentes region, and three case–control studies of birth defects in Texas (Agopian et al, 2013a, 2013b, 2013c) performed analyses of the state birth defects registry. The publication dates ranged from 1992 through 2013 with the most recent paper (Limousi et al, 2013) still in press at the time of this review.…”

“…Using various combinations of keywords “ATR,” “triazines,” “herbicides,” ”exposure,” “humans,” “health,” “outcomes,” “epidemiology,” “pregnancy,” “birth,” “congenital,” “defects,” “malformations,” “prematurity,” “gestational age (GA),” “delivery,” and “neonatal,” we selected relevant articles that investigated pregnancy outcomes associated with ATR and/or all triazine exposures in humans. The electronic database search strategy with corresponding medical subject headings and general keyword terms, and numbers of articles retrieved and examined at each stage of this process are presented in Appendix 2013a.…”

Using frogs faces to dissect the mechanisms underlying human orofacial defects

“…Association studies in humans suggest that defects in retinoic acid and FGF signals, hyperthyroidism and exposure to the herbicide atrazine could contribute to choanal atresia [21, 25]. However, it is unclear whether such causes of choanal atresia actually affect the developing embryonic mouth directly.…”

Descriptive and risk factor analysis for choanal atresia: The National Birth Defects Prevention Study, 1997–2007

“…Several additional case studies [Barbero et al, 2004; Greenberg, 1987; Johnsson et al, 1997], as well as a case–control study [Barbero et al, 2008], have described the occurrence of choanal atresia in offspring of mothers who reported prenatal use of anti-thyroid medication methimazole or propranolol. More recently, a case–control study using data from the TXBDR reported a positive association for isolated choanal atresia/severe stenosis among offspring born to mothers with residential exposure to the herbicide atrazine [Agopian et al, 2013]. Little attention has been given to additional environmental exposures that may contribute to choanal atresia.…”