الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Organophosphorus pesticides (OPs) are currently the most commonly utilized pesticides in the world. . Research suggests that prenatal exposure to OP pesticides is associated with a variety of harmful outcomes with irreversible damage to organ .So there is increasing concern regarding the their potential impacts on public health especially children and pregnant women. The aim of the present study was to assess possible effects of pesticide exposure on pregnant women ( neurological manifestation and laboratory findings) and on the fetus (maturity, birth weight and growth …….).Also study relationships between neurobehavioral effects of pregnant women ,clinical and laboratory findings and to clarify the impact of the suggested health education program about the safety measures of pesticide exposure. The study consisted of two phases: the first phase was a case control study and the second phase was an intervention study. It conducted during the period of October 2010 to June 2013.
The study was carried out on 140 pregnant women at age 18-35 years which meet inclusion and exclusion criteria. The participants were two groups:
Group I (pesticide exposed group ): It consists of forty pregnant women attending Manshat Sultan family health center, Menouf district, Menofiya.
Group II( control group): It consists of one hundred pregnant women attending southern health center in Shebin El kom.
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Summary
Procedure of the study: - all of them subjected to:
An interview: A simple and clear explanation of the research objectives and procedures were provided to each participant to obtaining an informed consent before patient’s participation in the study .
Filling the questionnaire including the personal data, questions about pesticide exposure . neurological symptoms and questions to assess their knowledge, attitude and practice (KAP) towards pesticide use and safety measures
Complete comprehensive clinical examination with special emphasis on weight , height and neurological examination.
Neurobehavioral battery test.
Laboratory investigations.
pregnancy outcomes assessment for their babies after delivery .
Health education program.
The study revealed the following results:
There was a significantly lower level of serum AChE in the exposed group (492.90±34.98 IU/L) compared to the control ones (1844.27±53.34IU/L) (p < 0.05).Also level of serum acetyl cholinesterase was lower in working in fields and other agricultural work (412.40U/ml) than in living within 20 meter of field (563.51U/ml) with significant difference (p<0.05).
Regarding pregnancy outcome it was founded that duration of gestational age , birth weight and head circumference in exposed group was(37.18±1.44weeks , 2733.3±197.87g and 33.18±0.33) lower than in control group(38.67±1.90,3100.6± 213.15and 35.58±0.19 respectively )
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Summary
with significant difference (p<0.001). Also there was a significant correlation between gestational age and birth weight and level of AChE (r = 0.34, 0.24 respectively) (p < 0.05).
Regarding neurological symptoms there was a significant increase reporting of blurred vision, headache, dizziness, difficulty in concentration, trouble in remembering, lack of concentration, feelings of depression and irritability, numbness and fatigue in exposed than control group (p < 0.001).Also the exposed with blurring of vision ,headache, feeling depressed and fatigue had significantly lower levels of AChE compared to exposed not having these neurological symptoms (p < 0.05)
Regarding neurological signs the exposed women showed significantly higher prevalence of tremors, abnormalities in the knee reflex, superficial sensation , coordination (p < 0.001),muscle tone and ankle reflex than control group (p < 0.05). Also exposed women with abnormalities of muscle tone , superficial sensation and in coordination had significantly lower levels of AChE compared to exposed not having these neuromuscular signs (p < 0.05).
Regarding laboratory investigations(RBCs), (WBCs), hemoglobin and monocyte count were significantly lower among the exposed group (p < 0.001)than control .Also ALT and Creatinine were significantly higher in the exposed group (P <0.001) than control group. also there was positive correlation between diminished acetyl cholinesterase level and RBCs , WBCs and Hemoglobin(p < 0.001) and negative correlation with AST (p < 0.05)
Regarding neurobehavioral Performance exposed group exhibited lower performance than controls in memory, Verbal abstraction, Letters
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cancel (errors), Trail making A and B(sec), Digit symbol test, Information. there was a significant negative correlation between AChE and digit span ,BVRT, Word recognition test, First and last name, Similarity, Information , PASAT and positive correlation between AChE and Letter cancel, Trail making A and B, Digit symbol test and Vocabulary test.
After implementation of health education program there was statistically significant increase in participant’s level of knowledge regarding routes of entry, symptom of long term OP pesticide exposure or toxicity, harmful to health of pregnant women and fetuses, First aids measure and protective measures. Also there is statistically significant improvement in participant’s attitude regarding the importance to read or to understand the label of OP pesticide, reuse of pesticide container , importance to wear protective clothes and if they are interested in knowing safe methods for the use of OP pesticides.
Regarding their practice it was also there was statistically significant increase in participant’s practice regarding Follow the product label, check expired date, eating or drinking during OP pesticide use, wash hand after use OP pesticide, bath or shower after use OP pesticide, store empty OP pesticides bottles or cans in specific place , reuse of empty OP pesticides bottles or cans and wearing protective clothes while using OP pesticide. Also it was founded that the score of Knowledge, Attitude and Practice of pesticide exposure among exposed group improved significantly after implementation of the health education program (P<0.05).
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It concluded that the seriousness of exposure to pesticide during pregnancy with harmful impact on them and their infant. That need much effort to increase awareness about pesticides. The individual behaviors need change well as changes in policy and work practices to protect families and children. However, the dissemination of knowledge and understanding gained through multiple efforts can lead to concrete changes that improve public and environmental health.