<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032018000100008</article-id>
<article-id pub-id-type="doi">10.31698/ped.45012018002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores de riesgo prenatales y su asociación a malformaciones congénitas en un hospital universitario de referencia]]></article-title>
<article-title xml:lang="en"><![CDATA[Prenatal risk factors and their association with congenital malformations at a university referral hospital]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ojeda]]></surname>
<given-names><![CDATA[Limpia Concepción]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benítez Leite]]></surname>
<given-names><![CDATA[Stela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Cátedra y Servicio de Pediatría]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<volume>45</volume>
<numero>1</numero>
<fpage>8</fpage>
<lpage>16</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032018000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032018000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032018000100008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Las malformaciones congénitas constituyen la segunda causa de mortalidad infantil en América del Sur, según datos de la OMS.  Objetivo:  Determinar la asociación entre los factores de riesgo prenatales y las malformaciones congénitas de pacientes internados en un hospital de referencia.  Material y Método:  Estudio retrospectivo, analítico de caso-control, corte transversal en pacientes internados desde Octubre 2014 a Octubre 2015 que cumplieron con criterios de inclusión y exclusión como caso; además en pacientes ambulatorios que cumplieron criterios de inclusión y exclusión como control. Con pareo 1:1 por edad y sexo. Instrumento: encuesta estructurada. Tamaño de muestra con variable cualitativa, valor de Z: 1,9, P: 4% (Porcentaje en población general 2 a 5%) de la variable principal, valor de D: 95% y el valor de p de 0,05, resultando N: 60 por grupo.  Resultados:  Se consideraron 66 casos y 66 controles pareados por edad y sexo; edades comprendidasde 1 mes a 15 años, media de 2 años (DE: +2,63), masculino 61%. Los Casos provenían 41% (27) del Interior del País y los Controles 11% (7). Las malformaciones más frecuentes fueron las del sistema nervioso central 29% (19/66) seguidas de las cardíacas 23% (15/66). El diagnóstico prenatal por ecografía obstétrica se observó en 33% de los casos (21/66). Al realizar regresión logística multivariada se encontró asociación entre malformaciones congénitas y antecedentes de malformaciones en la familia (OR 20,8, 95% CI 2,66- 162,2), antecedente de un hijo previo con síndrome genético (OR 8,84, 95% CI 1,35- 73,86) y falta de suplementación con ácido fólico antes o durante el embarazo (OR 3,44, 95% CI 1,49- 8,33) distancia de la vivienda de campos fumigados menor a 1 km (OR 3,75, 95% CI 0,98- 14,31) y exposición materna directa a plaguicidas(OR 4,51, 95% CI 1,77- 11,46).  Conclusión:  La falta de suplemento de ácido fólico, el antecedente de malformación congénita en la familia y la exposición materna a agroquímicos tuvieron asociación estadística significativa. Se plantea probable sesgo de la falta de pareo por Procedencia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Congenital malformations are the second- leading cause of infant mortality in South America, according to World Health Organization (WHO) data.  Objective:  To determine the association between prenatal risk factors and congenital malformations in patients hospitalized at a reference hospital.  Materials and Methods:  This was a retrospective, analytical, cross- sectional case-control study in inpatients from October 2014 to October 2015, who met inclusion and exclusion criteria definitions for a case; we also included outpatients who met the inclusion and exclusion criteria as controls. We performed 1:1 matching using age and sex. Instrument: we used a structured survey. We used a qualitative variable sample with a Z value of 1.9, and P value of 4% (Percentage in general population 2 to 5%) of the main variable, with a confidence interval of 95% and a p-value of 0.05, resulting in a needed N of 60 per group.  Results:  Sixty-six cases and 66 controls, matched by age and sex, were evaluated; the ages ranged from 1 month to 15 years, with an average age of 2 years (SD: + 2,63); males were 61%. 41% (27) of the cases and 11% (7) of the controls came from the interior of the country. The most frequent malformations were those of the central nervous system 29% (19/66) followed by cardiac, 23% (15/66). Prenatal diagnosis by obstetric ultrasound was made in 33% of cases (21/66). When performing multivariate logistic regression, an association was found between congenital malformations and a history of malformations in the family (OR 20.8, 95% CI, 2.66-162.2), a history of a previous child with a genetic syndrome (OR 8.84, 95% CI, 1.35- 73.86), lack of folic acid supplementation before or during pregnancy (OR 3.44, 95% CI, 1.49- 8.33), a distance from the house of fumigated fields less than 1 km (OR 3.75, 95% CI, 0.98- 14.31) and direct maternal exposure to pesticides (OR 4.51, 95% CI, 1.77- 11.46).  Conclusion:  The lack of folic acid supplementation, a history of congenital malformation in the family and maternal exposure to agrochemicals had significant statistical associations. There is a probable bias in the findings due to the lack of matching by provenance.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[Malformación congénita]]></kwd>
<kwd lng="es"><![CDATA[Plaguicidas]]></kwd>
<kwd lng="en"><![CDATA[Risk factors]]></kwd>
<kwd lng="en"><![CDATA[congenital malformation]]></kwd>
<kwd lng="en"><![CDATA[pesticides]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benitez-Leite]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Machi]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Malformaciones congénitas asociadas a agrotóxicos]]></article-title>
<source><![CDATA[Arch. Pediatr. Urug.]]></source>
<year>2009</year>
<volume>80</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>237-47</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mir]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Irala]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Ortigosa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Céspedes]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Caballero Bareiro]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Conocimientos de la Etiología y los Factores de Riesgo de los Defectos Congénitos]]></article-title>
<source><![CDATA[Pediatría.Pediatr. (Asunción)]]></source>
<year>2008</year>
<volume>35</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>95-100</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Davila]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Paraguay pionero en la prevención de los defectos congénitos]]></source>
<year>2015</year>
<publisher-name><![CDATA[OPS/OMS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zarate]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gracia]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Zarante]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluación de factores de riesgo asociados con malformaciones congénitas en el programa de vigilancia epidemiológica de malformaciones congénitas (ECLAMC) en Bogotá entre 2001 y 2010]]></article-title>
<source><![CDATA[Universitas Médica]]></source>
<year>2012</year>
<volume>53</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-25</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Karr]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pesticide exposure in children]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2012</year>
<volume>130</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>e1765-88</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ojeda]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Barraza]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Malformaciones congénitas y exposición a pesticidas]]></article-title>
<source><![CDATA[Rev. Méd. Chile]]></source>
<year>2000</year>
<volume>128</volume>
<page-range>399-404</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bernardi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Gentile]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluación del nivel de daño en el material genético de los niños expuestos a los pesticidas en la provincia de Cordoba.]]></article-title>
<source><![CDATA[Pediatr]]></source>
<year>2015</year>
<volume>113</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>126-32</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benedettia]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Nunesa]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[El daño genético en los trabajadores de soja expuestos a plaguicidas: Evaluación con los cometas y ensayos bucales de cytome de micronucleos. Mutationresearch Toxicologia Genetica y Mutagenesis Ambiental]]></source>
<year>2013</year>
<page-range>pag 28-33</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aiassal]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Mañas]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bosch]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Los plaguicidas. Su relación con la salud humana y ambiental en la provincia de Córdoba.]]></article-title>
<source><![CDATA[Experiencia medica]]></source>
<year>2009</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zavaleta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cortegana-Aranda]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zavaleta-Gutierrez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ocampo-Rugel]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Estrada-Alva]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores maternos asociados a malformaciones congénitas en recién nacidos de un Hospital de Trujillo, Perú]]></article-title>
<source><![CDATA[Rev. Cuerpo Méd.]]></source>
<year>2016</year>
<volume>9</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Molina-Giraldo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Alfonso-Ospina]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Parra-Meza]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lancheros-García]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rojas-Arias]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Acuña-Osorio]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalencia de malformaciones congénitas diagnosticadas por ultrasonido tres años de experiencia en una unidad de medicina materno fetal universitaria]]></article-title>
<source><![CDATA[Ginecologia y Obstetricia De Mexico]]></source>
<year>2015</year>
<volume>83</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>680-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paganelli]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gnazzo]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Lopez]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Carrasco]]></surname>
<given-names><![CDATA[AE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Glyphosate-based herbicides produce teratogenic effects on vertebrates by impairing retinoic acid signaling]]></article-title>
<source><![CDATA[Chem Res Toxicol]]></source>
<year>2010</year>
<volume>23</volume>
<page-range>1586-95</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carrasco]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Interview with journalista Dario Aranda]]></source>
<year>2010</year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seneff]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Nigh]]></surname>
<given-names><![CDATA[GL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Glyphosate and Anencephaly: Death by A Thousand Cuts.]]></article-title>
<source><![CDATA[J Neurol Neurobiol.]]></source>
<year>2017</year>
<volume>3</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kristensen]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Irgens]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Andersen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bye]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Sundheim]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Birth defects among offspring of Norwegian farmers]]></article-title>
<source><![CDATA[Epidemiology]]></source>
<year>1997</year>
<volume>8</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>537-44</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nazer H]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cifuentes O]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of congenital malformations at birth in Chilean maternity hospitals]]></article-title>
<source><![CDATA[Rev Med Chil]]></source>
<year>2014</year>
<volume>142</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1150-6</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Calvo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Biglieri]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of folic acid fortification on woman nutritional status on the prevalence of neural tube defects.]]></article-title>
<source><![CDATA[Arch. argent. Pediatr.]]></source>
<year>2008</year>
<volume>106</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Suárez-Obando]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ordóñez-Vásquez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zarante]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Defectos del tubo neural y ácido fólico patogenia, metabolismo y desarrollo embriológico: Revisión de la literatura]]></article-title>
<source><![CDATA[Rev Colomb Obstet Ginecol]]></source>
<year>2010</year>
<volume>61</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>49-60</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Canals C]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cavada C]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Nazer H]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identification of risk factors for congenital malformations]]></article-title>
<source><![CDATA[Rev Med Chil]]></source>
<year>2014</year>
<volume>142</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1431-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González Trujillo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Torres Clúa]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez Zorrilla]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Larrondo Castañeda]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[González Rodríguez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz Martínez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo asociados a las cardiopatías congenitas (Spanish)]]></article-title>
<source><![CDATA[Medicentro Electrónica]]></source>
<year>2011</year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>212-8</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bosch Núñez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Alcohol, tabaco y malformaciones congénitas labioalveolopalatinas]]></article-title>
<source><![CDATA[Medisan]]></source>
<year>2014</year>
<volume>18</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1329-33</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Heeren]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Tyler]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mandeya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Agricultural chemical exposures and birth defects in the Eastern Cape Province, South Africa A case-control study]]></article-title>
<source><![CDATA[EnvironHealth]]></source>
<year>2003</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Fletcher]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Benavides]]></surname>
<given-names><![CDATA[FG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Parental agricultural work and selected congenital malformations]]></article-title>
<source><![CDATA[Am J Epidemiol]]></source>
<year>1999</year>
<volume>149</volume>
<page-range>64-74</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lacasaña]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vázquez-Grameix]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Borja-Aburto]]></surname>
<given-names><![CDATA[VH]]></given-names>
</name>
<name>
<surname><![CDATA[Blanco-Muñoz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Romieu]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Aguilar-Garduño]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Maternal and paternal occupational exposure to agricultural work and the risk of anencephaly]]></article-title>
<source><![CDATA[Occup Environ Med]]></source>
<year>2006</year>
<volume>63</volume>
<page-range>649-56</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Medina-Carrillo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rivas Solís]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fernandez-Arguelles]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk for congenital malformations in pregnant women exposed to pesticides in the state of Nayarit, Mexico]]></article-title>
<source><![CDATA[Ginecol Obstet Mex]]></source>
<year>2002</year>
<volume>70</volume>
<page-range>538-44</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carmichael]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Residential agricultural pesticide exposures and risk of selected congenital heart defects among offspring in the San Joaquin Valley of California]]></article-title>
<source><![CDATA[Environ Res]]></source>
<year>2014</year>
<volume>135</volume>
<page-range>133-8</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carmichael]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Roberts]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Kegley]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Wolff]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypospadias and residential proximity to pesticide applications]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2013</year>
<volume>132</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>e1216-26</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Yi]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Jin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Organochlorine pesticide levels in maternal serum and risk of neural tube defects in offspring in Shanxi Province, China a case-control study]]></article-title>
<collab>et all</collab>
<source><![CDATA[Sci Total Environ]]></source>
<year>2014</year>
<volume>490</volume>
<page-range>1037-43</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kielb]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Herdt-Losavio]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bell]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Chapman]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Rocheleau]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Lawson]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Maternal periconceptional occupational exposure to pesticides and selected musculoskeletal birth defects]]></article-title>
<source><![CDATA[Int J Hyg Environ Health]]></source>
<year>2014</year>
<volume>217</volume>
<numero>2-3</numero>
<issue>2-3</issue>
<page-range>248-54</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gabel]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Jensen]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Andersen]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
<name>
<surname><![CDATA[Baelum]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Thulstrup]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Bonde]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Toft]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The risk of cryptorchidism among sons of women working in horticulture in Denmark a cohort study.Environ]]></article-title>
<source><![CDATA[Health]]></source>
<year>2011</year>
<volume>14</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>100</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[El-Helaly]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Abdel-Elah]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Haussein]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Shalaby]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Paternal occupational exposures and the risk of congenital malformations-a case-control study]]></article-title>
<source><![CDATA[Int J Occup Med Environ Health]]></source>
<year>2011</year>
<volume>24</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>218-27</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Seixas]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Lemos]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Lemos]]></surname>
<given-names><![CDATA[PV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Congenital defects and exposure to pesticides in São Francisco Valley]]></article-title>
<source><![CDATA[Rev Bras Ginecol Obstet]]></source>
<year>2011</year>
<volume>33</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>20-6</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gaspari]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sampaio]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Paris]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Audran]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Orsini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Neto]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Sultan]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High prevalence of micropenis in 2710 male newborns from an intensive-use pesticide area of Northeastern Brazil]]></article-title>
<source><![CDATA[Int J Androl]]></source>
<year>2012</year>
<volume>35</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>253-64</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Benitez-Leite]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Memorias del simposio internacional de controversia científica: transgénicos, plaguicidas y salud humana]]></source>
<year>2014</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
