Exposição aos agrotóxicos em Mato Grosso e ocorrência de malformações congênitas em crianças menores de cinco anos de idade atendidas em hospitais de Cuiabá : estudo caso-controle

Abstract

Congenital malformations are showing increasing relevance in the field of Public Health. One of the main risk factors are environmental pollutants and pesticides among them are configured to cause birth defects. Brazil used in agriculture in 2009 around 983 million liters of pesticides and Mato Grosso in their crops sprayed 103 million liters of herbicides, insecticides and fungicides, representing an exposure of 34.1 liters per capita. To assess exposure to pesticides in Mato Grosso and the occurrence of congenital malformations in children under five years of age treated at hospitals in Cuiabá. METHODS: A case-control, and for each case (child with congenital malformations) were selected two controls (children deprived of malformation) treated in hospitals in Cuiabá-MT, in the period from March to October 2011. Sample consisted of 137 cases and 274 controls. The data collection instrument was a structured questionnaire administered to the mothers of the two groups (case and control). Statistical analysis was performed descriptive, bivariate, stratified and logistic regression. In the bivariate analysis were identified crude associations between exposure and effect, stratified selection was performed for the main confounders or interaction. In logistic regression all variables were considered when the crude and stratified analyzes showed p-value less than 0.20, remaining in the final model, variables with significance level less than or equal to 0.05. RESULTS: Bivariate analysis showed significant association with the variables: mother reside in rural areas, being married or in consensual union and the father applied pesticides in their occupation in the periconceptional period of the child. In the final model of logistic regression were considered statistically significant paternal occupation and low maternal education, father who worked in agriculture and applied pesticides and low income per capita. Were more often found children with malformation only, prevailing on cleft lip and palate and musculoskeletal system. CONCLUSION: This study showed an association between parental exposure to pesticides in the periconceptional period and mothers in the first trimester and in the three months prior to pregnancy and births of children with congenital malformations.