Ebdrup Ninna Hinchely, Knudsen Ulla Breth, Schullehner Jörg, Arendt Linn Håkonsen, Liew Zeyan, Lyngsø Julie, Bay Bjørn, Clemmensen Pernille Jul, Sigsgaard Torben, Hansen Birgitte, Ramlau-Hansen Cecilia Høst
Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark.
Clin Epidemiol. 2022 Apr 13;14:475-487. doi: 10.2147/CLEP.S354926. eCollection 2022.
No studies have investigated if drinking water nitrate affects human fecundity. Experimental studies point at detrimental effects on fetal development and on female and male reproduction. This cohort study aimed to explore if female and male preconception and long-term exposure to nitrate in drinking water was associated with fecundability measured as time to pregnancy (TTP) or use of medically assisted reproduction (MAR) treatment.
The study population consisted of pregnant women recruited in their first trimester in 1996-2002 to the Danish National Birth Cohort. Preconception drinking-water nitrate exposure was estimated for the pregnant women (89,109 pregnancies), and long-term drinking water nitrate exposure was estimated from adolescence to conception for the pregnant women (77,474 pregnancies) and their male partners (62,000 pregnancies) by linkage to the national drinking water quality-monitoring database Jupiter. Difference in risk of TTP >12 months or use of MAR treatment between five exposure categories and log-transformed continuous models of preconception and long-term nitrate in drinking water were estimated. Binominal regression models for risk ratios (RR) were adjusted for age, occupation, education, population density, and lifestyle factors.
Nitrate in drinking water (median preconception exposure: 1.9 mg/L; median long-term exposure: 3.3 mg/L) was not associated with TTP >12 months or use of MAR treatment, neither in the categorical nor in the continuous models.
We found no association between preconception or long-term exposure to drinking water nitrate and fecundability.
尚无研究调查饮用水中的硝酸盐是否会影响人类生育能力。实验研究表明其对胎儿发育以及男女生殖功能有不良影响。本队列研究旨在探讨孕前及长期暴露于饮用水中的硝酸盐与以怀孕时间（TTP）或使用医学辅助生殖（MAR）治疗衡量的受孕能力之间是否存在关联。
研究人群包括1996 - 2002年孕早期招募进入丹麦国家出生队列的孕妇。通过与国家饮用水质量监测数据库Jupiter建立联系，估算孕妇（89,109次妊娠）的孕前饮用水硝酸盐暴露量，以及孕妇（77,474次妊娠）及其男性伴侣（62,000次妊娠）从青春期到受孕期间的长期饮用水硝酸盐暴露量。估计了五个暴露类别之间TTP>12个月或使用MAR治疗的风险差异，以及饮用水中孕前和长期硝酸盐的对数转换连续模型。风险比（RR）的二项回归模型针对年龄、职业、教育程度、人口密度和生活方式因素进行了调整。
饮用水中的硝酸盐（孕前暴露中位数：1.9毫克/升；长期暴露中位数：3.3毫克/升）与TTP>12个月或使用MAR治疗均无关联，无论是在分类模型还是连续模型中。
我们发现孕前或长期暴露于饮用水硝酸盐与受孕能力之间无关联。
