Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States.
Environ Int. 2023 Nov;181:108249. doi: 10.1016/j.envint.2023.108249. Epub 2023 Oct 4.
Animal and epidemiologic studies indicate that air pollution may adversely affect fertility. However, the level of evidence is limited and specific pollutants driving the association are inconsistent across studies.
We used data from a web-based preconception cohort study of pregnancy planners enrolled during 2013-2019 (Pregnancy Study Online; PRESTO). Eligible participants self-identified as female, were aged 21-45 years, resided in the United States (U.S.) or Canada, and were trying to conceive without fertility treatments. Participants completed a baseline questionnaire and bi-monthly follow-up questionnaires until conception or 12 months. We analyzed data from 8,747 participants (U.S.: 7,304; Canada: 1,443) who had been trying to conceive for < 12 cycles at enrollment. We estimated residential ambient concentrations of particulate matter < 2.5 µm (PM), nitrogen dioxide (NO), and ozone (O) using validated spatiotemporal models specific to each country. We fit country-specific proportional probabilities regression models to estimate the association between annual average, menstrual cycle-specific, and preconception average pollutant concentrations with fecundability, the per-cycle probability of conception. We calculated fecundability ratios (FRs) and 95% confidence intervals (CIs) and adjusted for individual- and neighborhood-level confounders.
In the U.S., the FRs for a 5-µg/m increase in annual average, cycle-specific, and preconception average PM concentrations were 0.94 (95% CI: 0.83, 1.08), 1.00 (95% CI: 0.93, 1.07), and 1.00 (95% CI: 0.93, 1.09), respectively. In Canada, the corresponding FRs were 0.92 (95% CI: 0.74, 1.16), 0.97 (95% CI: 0.87, 1.09), and 0.94 (95% CI: 0.80, 1.09), respectively. Likewise, NO and O concentrations were not strongly associated with fecundability in either country.
Neither annual average, menstrual cycle-specific, nor preconception average exposure to ambient PM, NO, and O were appreciably associated with reduced fecundability in this cohort of pregnancy planners.
动物和流行病学研究表明，空气污染可能对生育能力产生不利影响。然而，证据水平有限，并且具体的污染物在不同的研究中也不一致。
我们使用了 2013 年至 2019 年期间参加一项基于网络的妊娠计划者孕前队列研究（妊娠在线研究；Presto）的数据。合格的参与者自我认定为女性，年龄在 21-45 岁之间，居住在美国（美国）或加拿大，并且正在尝试不进行生育治疗的怀孕。参与者在入组前完成了基线问卷和每两个月一次的随访问卷，直到怀孕或 12 个月。我们分析了 8747 名参与者（美国：7304 名；加拿大：1443 名）的数据，他们在入组时的受孕尝试<12 个周期。我们使用针对每个国家的经过验证的时空模型来估计居住环境中<2.5µm（PM）、二氧化氮（NO）和臭氧（O）的颗粒物质浓度。我们针对每个国家的特定情况，使用比例概率回归模型来估计年度平均、月经周期特定和受孕前平均污染物浓度与生育能力（即每个周期受孕的概率）之间的关系。我们计算了生育能力比（FRs）和 95%置信区间（CI），并调整了个体和邻里水平的混杂因素。
在美国，年度平均、周期特异性和受孕前平均 PM 浓度每增加 5µg/m，FRs 分别为 0.94（95%CI：0.83，1.08）、1.00（95%CI：0.93，1.07）和 1.00（95%CI：0.93，1.09）。在加拿大，相应的 FRs 分别为 0.92（95%CI：0.74，1.16）、0.97（95%CI：0.87，1.09）和 0.94（95%CI：0.80，1.09）。同样，NO 和 O 浓度与这一妊娠计划者队列的生育能力也没有明显关联。
在这个妊娠计划者队列中，年度平均、月经周期特异性或受孕前平均暴露于环境 PM、NO 和 O 与生育能力降低均无明显关联。
