Pesticides are widely used globally. Due to their widespread use, exposure to pesticides is of concern. In addition to occupational exposure, residential exposure during pesticide application is a concern for those living in or near agricultural areas. The objective of this study was to analyze the association between residential proximity to agricultural pesticide use and birth outcomes. The association between residential proximity to agricultural land use as pesticide exposure and birth outcomes was explored in a birth cohort including 283 pregnant women from a medical center in Hualien during 2013-2016. In the third trimester, we collected demographic information and the residential addresses of pregnant women via structured questionnaires. After delivery, newborn birth weight, gestational age, and head circumference were collected from medical records. Maternal residential address during pregnancy was collected for geospatial mapping. The percentages of farmland area within circular buffers of different sizes were applied to estimate pesticide exposure. Associations between residential proximity to agricultural land use as pesticide exposure and birth outcomes were analyzed by multiple linear regression analyses. A significantly smaller head circumference was associated with agricultural farmland located within 400m (β = - 0.51 [95% CI, - 0.99, - 0.03], P = 0.037) and 500m (β = - 0.67 [95% CI, - 1.14, - 0.19], P = 0.006) radii of residences in the tertile 2 group. A significantly smaller head circumference was also associated with dry farming area within 400m (β = - 0.70 [95% CI, - 1.17, - 0.24], P = 0.003) and 500m (β = - 0.81 [95% CI, - 1.27, - 0.34], P = 0.001) radii of residences in the tertile 2 group. The multivariate linear regression analyses did not show any significant association between residential farmland area and birth weight or gestational age. In conclusion, residential proximity to agricultural land use as pesticide exposure was associated with negative infant birth outcomes, especially a small head circumference. In the future, agricultural land use information could be combined with biological samples to more accurately assess exposure in pregnant women.
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