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Introduction: Areas with higher agricultural production have higher rates of abortion and malformation, probable related to pesticides., Objective: To compare the rates of early abortion and fetal malformation in agricultural and nonagricultural areas., Method: A survey was carried out on fetal deaths in children weighing less than 500 g or gestational age less than 22 weeks and fetal malformations in live births., Results: From 1996 to 2018, there was an increase in the rates of abortion and, albeit to a lesser extent, malformation. The areas of greater agricultural production have higher rates of fetal mortality and malformation than the others., Conclusions: The study suggests that areas with higher use of pesticides have higher rates of abortion and fetal malformations than the others, requiring further observational studies, reducing confounders inherent to the ecological study., Competing Interests: de Fátima Alvim Braga, Cozendey-Silva, dos Santos Martins, da Silva Santos, Silva, Assumpção, and Waissmann have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2023 American College of Occupational and Environmental Medicine.)