Adverse reproductive outcomes were sought via medical records of 14 central Arkansas hospitals serving a five county area encompassing 28, 102 live births in the 1980 to 1982 study period. This population-based study estimated the overall congenital anomaly case incidence to be 3.5 percent of live births. Information on pregnancy history of the cases or on parental occupations was often not recorded in the medical records of infant or mother, precluding the use of these records for many etiologic investigations. Fetal wastage cases found through hospital sources encompassed 86 percent of the number reported to the Department of Health. Autopsies were performed in only 16 percent of fetal death cases. Many of the fetal death cases not subjected to autopsy had no apparent cause of death listed; reasons for this lack of investigation warrant further study. These pregnancy outcome data have been correlated with agricultural pesticide usage and can be examined in a variety of environmental contexts for development and testing of etiologic hypotheses.