Fetal and neonatal deaths and congenital anomalies associated with open dumpsites in Alaska Native villages

Objective. To determine if women living in Alaska Native villages with open dumpsites ranked as higher hazard have higher rates of adverse pregnancy outcomes than women living in villages with sites that have lower hazard rankings. Adverse pregnancy outcomes examined included fetal and neonatal death and congenital anomalies. Study Design. A population-based retrospective cohort study. Methods. Birth records from 1997-2001 were used to identify the 10 360 eligible infants born to mothers who resided in 197 Alaska Native villages with dumpsite rankings. Exposure variables were derived from hazard rankings of dumpsites. Covariates were obtained from both birth certificate information and village-specific characteristics. Results. Neither crude, nor adjusted estimates detected a statistically significant difference in rates between exposure levels, although adjusted estimates were positive in all congenital anomaly categories, except gastrointestinal defects. Infants born to mothers residing in villages with high hazard dumpsite contents were more likely (RR=4.27; 95% CI: 1.76, 10.36) to have anomalies classified as other defects. Other hazard factors were not significant predictors for any of the adverse outcomes examined. Conclusions. This is the first study to evaluate fetal and neonatal deaths and congenital anomalies associated with open dumpsites in Alaska Native villages. Problems with the study include a population-based exposure measurement, small sample size, and biases related to birth record information. Future studies should include more comprehensive registries of congenital anomalies.