Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Environ Int. 2020 Jun;139:105693. doi: 10.1016/j.envint.2020.105693. Epub 2020 Apr 4.
Intake of conventionally-grown fruits and vegetables with higher levels of pesticide residue contamination has been associated with poorer semen quality and lower probability of live birth among couples undergoing fertility treatment. We examined the association between dietary intake of pesticide residues and fecundability, the per cycle probability of conception, in a preconception cohort of pregnancy planners. We enrolled women aged 21-45 years who were attempting to conceive without use of fertility treatment into Pregnancy Study Online (PRESTO) from June 2013 through September 2019. Participants completed a baseline questionnaire on demographics, lifestyle factors, and medical and reproductive histories, and bimonthly follow-up questionnaires for up to 12 months or until reported conception. Ten days after baseline, participants completed the National Cancer Institute's Diet History Questionnaire II, a validated food frequency questionnaire. Using data from the USDA Pesticide Data Program, we classified fruits and vegetables as having high or low pesticide residues using a validated method. We examined the relation between greater intake of high- and low-pesticide residue fruits and vegetables with fecundability using proportional probabilities regression models, adjusted for potential confounders and accounting for consumption of organic produce. We restricted our analysis to 5234 women who had been attempting conception for ≤6 cycles at study entry, and further stratified by pregnancy attempt time at study entry (<3 vs. 3-6 cycles) to evaluate potential for reverse causation. Intakes of high- and low-pesticide residue fruits and vegetables were not appreciably related to fecundability in the full sample, or among women trying to conceive for <3 cycles at study entry. However, among women trying to conceive for 3-6 cycles at study entry, both high- and low-pesticide residue fruit and vegetable intakes were strongly inversely related to fecundability, indicating potential reverse causation bias. These results do not support the hypothesis that intake of pesticide residues from conventionally-grown fruits and vegetables is harmful to fertility, although non-differential exposure misclassification may have attenuated our findings.
常规种植的水果和蔬菜中农药残留水平较高，与接受生育治疗的夫妇的精液质量较差和活产概率较低有关。我们在妊娠计划者的预受孕队列中检查了饮食中农药残留与生育力之间的关系，即每个周期受孕的概率。我们招募了年龄在 21-45 岁之间、不使用生育治疗尝试怀孕的女性，将其纳入妊娠在线研究（Presto），招募时间为 2013 年 6 月至 2019 年 9 月。参与者完成了一份关于人口统计学、生活方式因素以及医疗和生殖史的基线问卷，并在最多 12 个月或报告怀孕前每两个月完成一次随访问卷。在基线后 10 天，参与者完成了美国国立癌症研究所的饮食史问卷 II，这是一种经过验证的食物频率问卷。我们使用美国农业部农药数据计划的数据，使用经过验证的方法将水果和蔬菜分为高农药残留和低农药残留。我们使用比例概率回归模型，在考虑潜在混杂因素和有机农产品消费的情况下，检查高和低农药残留水果和蔬菜摄入量与生育力之间的关系。我们将分析限制在 5234 名在研究开始时尝试怀孕 ≤6 个周期的女性中，并根据研究开始时的妊娠尝试时间（<3 个周期与 3-6 个周期）进一步分层，以评估潜在的反向因果关系。在全样本中，或在研究开始时尝试怀孕 <3 个周期的女性中，高和低农药残留水果和蔬菜的摄入量与生育力没有明显关系。然而，在研究开始时尝试怀孕 3-6 个周期的女性中，高和低农药残留水果和蔬菜的摄入量与生育力呈强烈负相关，表明存在潜在的反向因果关系偏差。这些结果不支持摄入常规种植的水果和蔬菜中的农药残留对生育力有害的假设，尽管非差异暴露错误分类可能会削弱我们的发现。
