Fetal Solvent Syndrome
Abstract & Commentary
Synopsis: A study concludes that occupational exposure to organic solvents during pregnancy is associated with an increased risk of major fetal malformations, especially in women who are symptomatic. Such exposure to organic solvents should be minimized during pregnancy.
Source: Khattak S, et al. JAMA 1999;281:1106-1109.
To determine pregnancy and fetal outcome associated with maternal occupational exposure to organic solvents, Khattak and associates conducted a prospective, observational, controlled study of 125 women exposed to organic solvents and 125 control subjects matched for age, gravidity, and smoking and drinking status. The exposed women were factory workers, laboratory technicians, artists, and printing industry workers. The organic solvents to which they were exposed included aliphatic acid and aromatic hydrocarbons, phenols, trichloroethylene, xylene, vinyl chloride, acetone, and other related compounds. Thirteen major malformations were observed in the exposed women and only one in the control population. The malformations involved a wide range of organ systems including the heart and central nervous system. Women who were symptomatic from their exposure, including irritation of the eyes or respiratory system, breathing difficulties, and headache, delivered 12 of the 13 malformed infants. Those who were exposed for seven or more months were likely to have fetal distress in labor. While their infants had birth weights that were nearly 400 g lower, low birth weight was not increased. Review of past obstetric history revealed a higher rate of prior miscarriages in the exposed population.
Khattak et al conclude that occupational exposure to organic solvents during pregnancy is associated with an increased risk of major fetal malformations, especially in women who are symptomatic. Such exposure to organic solvents should be minimized during pregnancy.
COMMENT BY STEVEN G. GABBE, MD
This prospective investigation, the first to examine fetal malformations associated with organic solvents, supports earlier retrospective studies. Most of the women worked in factories or as laboratory technicians. They were exposed to a wide variety of organic solvents, perhaps explaining the wide range of malformations seen. The timing and extent of the exposure are also important factors.
Women considering a pregnancy should be asked about occupational hazards including exposures to dangerous chemicals at home. Clearly, close and continuous exposure to organic solvents should be avoided.
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