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Congenital anomalies associated with oil and gas development and resource extraction: a population-based retrospective cohort study in Texas



Oil and gas extraction-related activities produce air and water pollution that contains known and suspected teratogens. To date, health impacts of in utero exposure to these activities is largely unknown.


We investigated associations between in utero exposure to oil and gas extraction activity in Texas, one of the highest producers of oil and gas, and congenital anomalies.


We created a population-based birth cohort between 1999 and 2009 with full maternal address at delivery and linked to the statewide congenital anomaly surveillance system (n = 2,234,138 births, 86,315 cases). We examined extraction-related exposures using tertiles of inverse distance-squared weighting within 5 km for drilling site count, gas production, oil production, and produced water. In adjusted logistic regression models, we calculated odds of any congenital anomaly and 10 specific organ sites using two comparison groups: 1) 5 km of future drilling sites that are not yet operating (a priori main models), and 2) 5–10 km of an active well.


Using the temporal comparison group, we find increased odds of any congenital anomaly in the highest tertile exposure group for site count (OR: 1.25; 95% CI: 1.21, 1.30), oil production (OR: 1.08; 95% CI: 1.04, 1.12), gas production (1.20; 95% CI: 1.17, 1.23), and produced water (OR: 1.17; 95% CI: 1.14, 1.20). However, associations did not follow a consistent exposure-response pattern across tertiles. Associations are highly attenuated, but still increased, with the spatial comparison group in the highest tertile exposure group. Cardiac and circulatory defects are strongly and consistently associated with all exposure metrics.


Increased odds of congenital anomalies, particularly cardiac and circulatory defects, were associated with exposures related to oil and gas extraction in this large population-based study. Future research is needed to confirm findings, examine specific exposure pathways, and identify potential avenues to reduce exposures among local populations.


About 5% of the U.S. population (~17.6 million people) resides within 1.6 km of an active oil or gas extraction site, yet the influence of this industry on population health is not fully understood. In this analysis, we examined associations between oil and gas extraction-related exposures and congenital anomalies by organ site using birth certificate and congenital anomaly surveillance data in Texas (1999–2009). Increased odds of congenital anomalies, particularly cardiac and circulatory defects, were associated with exposures related to oil and gas extraction in this large population-based study. Future research is needed to confirm these findings.

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Fig. 1: Spatial distribution of oil and gas development in Texas, 1985–2019.
Fig. 2: Associations between nearest active spud to a maternal residence and odds of congenital anomalies.

Data availability

The health data used in this study can be obtained for similar research purposes on request from the Texas Department of State Health Services, and the oil and gas development data can be obtained for similar research purposes from Enverus DrillingInfo. All other exposure data is referenced in the main text.


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This work is partially funded by the National Institute of Environmental Health Sciences, National Institutes of Health [Award Number: F31 ES029801] and the National Center for Advancing Translational Sciences, National Institutes of Health [Award Number: TL1 TR002371]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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MDW and PH were responsible for design; SEC and PH acquired the data; MDW and PH were responsible for analysis and interpretation of the data; MDW was responsible for leading the drafting of the manuscript. MDW, SEC, and PH contributed to writing and editing the manuscript. All authors were responsible for final approval of the version to be published and agreement to be accountable for all aspects of the work.

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Correspondence to Mary D. Willis.

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Willis, M.D., Carozza, S.E. & Hystad, P. Congenital anomalies associated with oil and gas development and resource extraction: a population-based retrospective cohort study in Texas. J Expo Sci Environ Epidemiol 33, 84–93 (2023).

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  • Natural gas development
  • Oil extraction
  • Birth defect
  • Congenital anomaly
  • Epidemiology


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