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Li Y, Yang Z. The causal effect of exposure to air pollution on risk of adverse pregnancy outcomes: A two-sample Mendelian randomisation study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172234. [PMID: 38615756 DOI: 10.1016/j.scitotenv.2024.172234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/10/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Epidemiological studies have examined the relation between air pollution (NOx, NO2, PM2.5, PM2.5-10, and PM10) and adverse pregnancy outcomes (APOs). There's increasing evidence that air pollution increases the risk of APOs. However, the results of these studies are controversial, and the causal relation remains uncertain. We aimed to assess whether a genetic causal link exists between air pollution and APOs and the potential effects of this relation. METHODS A novel two-sample Mendelian randomisation (MR) study used pooled data from a large-scale complete genome correlation study. The primary analysis method was inverse variance weighting (IVW), which explored the expose-outcome relationship for assessing single nucleotide polymorphisms (SNPs) associated with air pollution. Further sensitivity analysis, including MR-PRESSO, MR-Egger regression, and leave-one analysis, was used to test the consistency of the results. RESULTS There was a significant correlation between air pollution-related SNPs and APOs. A robust causal link was found between genetic susceptibility to air pollution and APOs. CONCLUSIONS Our MR analysis reveals a genetic causal relation between air pollution and APOs, which may help provide new insights into further mechanisms and clinical studies in air pollution-mediated APOs.
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Affiliation(s)
- Yanhui Li
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, 107 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China.
| | - Zhou Yang
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, 107 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China
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Trees IR, Saha A, Putnick DL, Clayton PK, Mendola P, Bell EM, Sundaram R, Yeung EH. Prenatal exposure to air pollutant mixtures and birthweight in the upstate KIDS cohort. ENVIRONMENT INTERNATIONAL 2024; 187:108692. [PMID: 38677086 DOI: 10.1016/j.envint.2024.108692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/02/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Single-pollutant models have linked prenatal PM2.5 exposure to lower birthweight. However, analyzing air pollutant mixtures better captures pollutant interactions and total effects. Unfortunately, strong correlations between pollutants restrict traditional methods. OBJECTIVES We explored the association between exposure to a mixture of air pollutants during different gestational age windows of pregnancy and birthweight. METHODS We included 4,635 mother-infant dyads from a New York State birth cohort born 2008-2010. Air pollution data were sourced from the EPA's Community Multiscale Air Quality model and matched to the census tract centroid of each maternal home address. Birthweight and gestational age were extracted from vital records. We applied linear regression to study the association between prenatal exposure to PM2.5, PM10, NOX, SO2, and CO and birthweight during six sensitive windows. We then utilized Bayesian kernel machine regression to examine the non-linear effects and interactions within this five-pollutant mixture. Final models adjusted for maternal socio-demographics, infant characteristics, and seasonality. RESULTS Single-pollutant linear regression models indicated that most pollutants were associated with a decrement in birthweight, specifically during the two-week window before birth. An interquartile range increase in PM2.5 exposure (IQR: 3.3 µg/m3) from the median during this window correlated with a 34 g decrement in birthweight (95 % CI: -54, -14), followed by SO2 (IQR: 2.0 ppb; β: -31), PM10 (IQR: 4.6 µg/m3; β: -29), CO (IQR: 60.8 ppb; β: -27), and NOX (IQR: 7.9 ppb; β: -26). Multi-pollutant BKMR models revealed that PM2.5, NOX, and CO exposure were negatively and non-linearly linked with birthweight. As the five-pollutant mixture increased, birthweight decreased until the median level of exposure. DISCUSSION Prenatal exposure to air pollutants, notably PM2.5, during the final two weeks of pregnancy may negatively impact birthweight. The non-linear relationships between air pollution and birthweight highlight the importance of studying pollutant mixtures and their interactions.
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Affiliation(s)
- Ian R Trees
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Abhisek Saha
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Priscilla K Clayton
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, University at Buffalo, United States
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, United States
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States.
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States.
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Wesselink AK, Kirwa K, Hystad P, Kaufman JD, Szpiro AA, Willis MD, Savitz DA, Levy JI, Rothman KJ, Mikkelsen EM, Laursen ASD, Hatch EE, Wise LA. Ambient air pollution and rate of spontaneous abortion. ENVIRONMENTAL RESEARCH 2024; 246:118067. [PMID: 38157969 PMCID: PMC10947860 DOI: 10.1016/j.envres.2023.118067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Spontaneous abortion (SAB), defined as a pregnancy loss before 20 weeks of gestation, affects up to 30% of conceptions, yet few modifiable risk factors have been identified. We estimated the effect of ambient air pollution exposure on SAB incidence in Pregnancy Study Online (PRESTO), a preconception cohort study of North American couples who were trying to conceive. Participants completed questionnaires at baseline, every 8 weeks during preconception follow-up, and in early and late pregnancy. We analyzed data on 4643 United States (U.S.) participants and 851 Canadian participants who enrolled during 2013-2019 and conceived during 12 months of follow-up. We used country-specific national spatiotemporal models to estimate concentrations of particulate matter <2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) during the preconception and prenatal periods at each participant's residential address. On follow-up and pregnancy questionnaires, participants reported information on pregnancy status, including SAB incidence and timing. We fit Cox proportional hazards regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of time-varying prenatal concentrations of PM2.5, NO2, and O3 with rate of SAB, adjusting for individual- and neighborhood-level factors. Nineteen percent of pregnancies ended in SAB. Greater PM2.5 concentrations were associated with a higher incidence of SAB in Canada, but not in the U.S. (HRs for a 5 μg/m3 increase = 1.29, 95% CI: 0.99, 1.68 and 0.94, 95% CI: 0.83, 1.08, respectively). NO2 and O3 concentrations were not appreciably associated with SAB incidence. Results did not vary substantially by gestational weeks or season at risk. In summary, we found little evidence for an effect of residential ambient PM2.5, NO2, and O3 concentrations on SAB incidence in the U.S., but a moderate positive association of PM2.5 with SAB incidence in Canada.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, USA.
| | - Kipruto Kirwa
- Department of Environmental Health, Boston University School of Public Health, USA
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Epidemiology, and Medicine, University of Washington School of Public Health, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington School of Public Health, USA
| | - Mary D Willis
- Department of Epidemiology, Boston University School of Public Health, USA
| | - David A Savitz
- Department of Epidemiology, Brown University School of Public Health, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, USA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, USA
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Denmark
| | - Anne Sofie Dam Laursen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Denmark
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, USA
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Das M, Patidar H, Singh M. Understanding trimester-specific miscarriage risk in Indian women: insights from the calendar data of National Family Health Survey (NFHS-5) 2019-21. BMC Womens Health 2024; 24:63. [PMID: 38263129 PMCID: PMC10804530 DOI: 10.1186/s12905-023-02838-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/09/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The primary public health issue, especially in low- and middle-income countries, is early pregnancy loss driven by miscarriage. Understanding early pregnancy losses and the characteristics of mothers who have miscarriages is essential to creating effective reproductive health strategies. Thus, this study's primary goal is to delve into the factors which impact miscarriages that take place prior to and following the first 12 weeks of gestation. METHODS The bivariate analysis was employed to determine the frequency of miscarriages. The factors associated with miscarriages in the first (≤12 weeks) and second & above (> 12 weeks) trimesters of pregnancy were then examined using a generalised linear regression model, with 95% confidence intervals. Finally, we use ArcGIS to illustrate the prevalence of miscarriage in the districts of India. RESULTS Our result shows that miscarriages occur often in India (4.9%), with 23% of cases occurring in the first trimester (≤12 weeks). In our bivariate analysis, we identified several factors associated with a higher prevalence of miscarriages in India. It was found that mothers aged thirty years or older, residing in urban areas, with less than ten years of education, belonging to the richest wealth quantile, expressing a desire for more children, having no demand for contraception, and possessing no parity experienced a higher prevalence of miscarriage in total pregnancies in India. On the other hand, the generalised linear model's findings show that mothers who are thirty years of age or older, practise other religions, live in urban areas, are members of other castes, want more children, marry before the age of eighteen, and meet their contraceptive needs are more likely to have miscarriages in total pregnancy. However, there is a larger likelihood of miscarriage in the first trimester (≤12 weeks) for mothers who follow other religions, live in urban areas, are from Other Backward Class (OBC), get married before the age of eighteen, and fall into the middle and upper wealth quantiles. A mother is more likely to miscarriage in the second & above (> 12 weeks) trimesters if she is older than thirty, from other castes, wants more children, has moderate media exposure, marries before turning eighteen, meets her contraceptive needs, and does not feel the need for contraception. After accounting for socioeconomic characteristics, all results were statistically significant. CONCLUSIONS Given the substantial number of miscarriages in India, police need to improve planning and guidance in order to lower pregnancy loss due to miscarriage. Miscarriage rates may be significantly decreased by enhancing the availability and quality of reproductive health care infrastructure, particularly in rural areas.
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Affiliation(s)
- Milan Das
- International Institute for Population Sciences, Mumbai, India
| | | | - Mayank Singh
- International Institute for Population Sciences, Mumbai, India.
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Dimassi H, Alameddine M, Sabra N, El Arnaout N, Harb R, Hamadeh R, El Kak F, Shanaa A, Mossi MO, Saleh S, AlArab N. Maternal health outcomes in the context of fragility: a retrospective study from Lebanon. Confl Health 2023; 17:59. [PMID: 38093261 PMCID: PMC10720064 DOI: 10.1186/s13031-023-00558-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND AND AIMS The Lebanese healthcare system faces multiple challenges including limited capacities, shortage of skilled professionals, and inadequate supplies, in addition to hosting a significant number of refugees. While subsidized services are available for pregnant women, representing the majority of the refugee population in Lebanon, suboptimal access to antenatal care (ANC) and increased maternal mortality rates are still observed, especially among socioeconomically disadvantaged populations. This study aimed to review the maternal health outcomes of disadvantaged Lebanese and refugee pregnant women seeking ANC services at primary healthcare centers (PHCs) in Lebanon. METHODS A retrospective chart review was conducted at twenty PHCs in Lebanon, including Ministry of Public Health (MOPH) and United Nations Relief and Works Agency for Palestine refugees (UNRWA) facilities. Data was collected from medical charts of pregnant women who visited the centers between August 2018 and August 2020. Statistical analysis was performed to explore outcomes such as the number of ANC visits, delivery type, and onset of delivery, using bivariate and multivariable logistic regression models. RESULTS In the study, 3977 medical charts were analyzed. A multivariate logistic regression analysis, revealed that suboptimal ANC visits were more common in the Beqaa region and among women with current abortion or C-section. Syrians had reduced odds of C-sections, and Beqaa, Mount Lebanon, and South Lebanon regions had reduced odds of abortion. Suboptimal ANC visits and history of C-section increased the odds of C-section and abortion in the current pregnancy. As for preterm onset, the study showed an increased likelihood for it to occur when being Palestinian, having current C-section delivery, experiencing previous preterm onset, and enduring complications at the time of delivery. CONCLUSION This study suggests the need for low-cost interventions aiming at enhancing access to ANC services, especially among pregnant women in fragile settings.
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Affiliation(s)
- Hani Dimassi
- School of Pharmacy, Lebanese American University, Beirut, Lebanon
| | - Mohamad Alameddine
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nadine Sabra
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Nour El Arnaout
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Ranime Harb
- School of Pharmacy, Lebanese American University, Beirut, Lebanon
| | | | - Faysal El Kak
- Faculty of Health Sciences, American University of Beirut (AUB), Beirut, Lebanon
- Department of Obstetrics Gynecology, American University of Beirut, Medical Center (AUB) Medical Center, Beirut, Lebanon
| | - Abed Shanaa
- United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Beirut, Lebanon
| | | | - Shadi Saleh
- Global Health Institute, American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Natally AlArab
- Global Health Institute, American University of Beirut, Beirut, Lebanon.
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Li J, Yang B, Liu L, Gu J, Cao M, Wu L, He J. Relationship between air pollutants and spontaneous abortion in a coal resource valley city: a retrospective cohort study. J Matern Fetal Neonatal Med 2023; 36:2281876. [PMID: 37968927 DOI: 10.1080/14767058.2023.2281876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE Pollutants in the atmosphere have been linked to poor pregnancy outcomes in women. However, such investigations are scarce in metropolitan northern China. The major exposure window of air pollution affecting pregnant women is also unknown. METHODS For the analysis, this retrospective cohort study enrolled 6960 pregnant women recorded at Tongchuan People's Hospital from January 2018 to December 2019. Pollutant concentration values from the nearest monitoring station to the pregnant women were used to estimate exposure doses for each exposure window. Logistic regression models were created to investigate the connection between pollutants and spontaneous abortion while controlling for confounding factors. RESULTS PM2.5 was a risk factor for spontaneous abortion in T3 (30-60 days before the first day of the last menstrual period [LMP]), (OR: 1.305, 95% CI: 1.143-1.490) and T4 (60-90 days before the first day of the LMP),(OR: 1.450, 95% CI: 1.239-1.696) after controlling for covariates. In the same window, PM10 was a risk factor (OR: 1.308, 95% CI: 1.140-1.500), (OR: 1.386, 95% CI: 1.184-1.621). In T2 (30 days before the first day of the LMP), T3, and T4, SO2 was a risk factor for spontaneous abortion (OR: 1.185, 95% CI: 1.025-1.371), (OR: 1.219, 95% CI: 1.071-1.396), (OR: 1.202, 95% CI: 1.040-1.389). In T3 and T4, NO2 was a risk factor (OR: 1.171, 95% CI: 1.019- 1.346), (OR: 1.443, 95% CI: 1.259-1.655). In T1 (from the first day of the LMP to the date of abortion), O3 was found to be a risk factor (OR: 1.366, 95% CI: 1.226-1.521). CONCLUSION Exposure to high levels of air pollutants before and during pregnancy may be a risk factor for spontaneous abortion in pregnant women. This study further illustrates the importance of reducing air pollution emissions.
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Affiliation(s)
- Jimin Li
- Medical School of Yan'an University, Yan'an, Shaanxi, China
| | - Boya Yang
- Medical School of Yan'an University, Yan'an, Shaanxi, China
| | - Lang Liu
- Medical School of Yan'an University, Yan'an, Shaanxi, China
| | - Jiajia Gu
- Medical School of Yan'an University, Yan'an, Shaanxi, China
| | - Meiying Cao
- Medical School of Yan'an University, Yan'an, Shaanxi, China
| | - Lili Wu
- Medical Records Room of Tongchuan People's Hospital, Tongchuan, Shaanxi, China
| | - Jinwei He
- Medical School of Yan'an University, Yan'an, Shaanxi, China
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Tong M, Lin W, Liu H, Gong J, Zhang JJ, Xue T. Gestational age modifies the association between exposure to fine particles and fetal death: findings from a nationwide epidemiological study in the contiguous United States. Environ Health 2023; 22:65. [PMID: 37705052 PMCID: PMC10500914 DOI: 10.1186/s12940-023-01016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/01/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUNDS The vulnerability of fetuses differs at different developmental stages, in response to environmental stressors such as fine particulate matter (PM2.5), a ubiquitous air pollutant. Whether gestational age (GA) modifies the association between prenatal fine particulate matter (PM2.5) exposure and fetal death remains unclear. METHODS We selected approximately 47.8 million eligible United States (US) livebirth and fetal death (defined as a termination at a GA of 20-43 weeks) records from 1989 to 2004. For each record, we took the level of prenatal exposure to PM2.5 as the average concentration in the mother's residential county during the entire gestational period, or a specific trimester (i.e., GA-specific exposure), according to well-established estimates of monthly levels across the contiguous US. First, we evaluated the associations between PM2.5 exposure and fetal death at a specific GA (i.e., GA-specific outcome) using five different logit models (unadjusted, covariate-adjusted, propensity-score, double robust, and diagnostic-score models). Double robust model was selected as the main model due to its advantages in causal inference. Then, we conducted meta-analyses to pool the estimated GA-specific associations, and explored how the pooled estimates varied with GA. RESULTS According to the meta-analysis, all models suggested gestational PM2.5 exposure was associated with fetal death. However, there was slight heterogeneity in the estimated effects, as different models revealed a range of 3.6-10.7% increase in the odds of fetal death per 5-µg/m3 increment of PM2.5. Each 5-µg/m3 increase in PM2.5 exposure during the entire gestation period significantly increased the odds of fetal death, by 8.1% (95% confidence interval [CI]: 5.1-11.2%). In terms of GA-specific outcomes, the odds of fetal death at a GA of 20-27, 28-36, or ≥ 37 weeks increased by 11.0% (5.9-16.4%), 5.2% (0.4-10.1%), and 8.3% (2.5-14.5%), respectively. In terms of GA-specific exposure, the odds of fetal death increased by 6.0% (3.9-8.2%), 4.1% (3.9-8.2%), and 4.3% (0.5-8.2%) with 5-µg/m3 increases in PM2.5 exposure during the first, second, and third trimester, respectively. The association had the largest effect size (odds ratio = 1.098, 95% CI: 1.061-1.137) between PM2.5 exposure during early gestation (i.e., first trimester) and early fetal death (i.e., 20-27 weeks). CONCLUSIONS Prenatal exposure to PM2.5 was significantly associated with an increased risk of fetal death. The association was varied by gestational-age-specific exposures or outcomes, suggesting gestation age as a potential modifier on the effect of PM2.5. The fetus was most vulnerable during the early stage of development to death associated with PM2.5 exposure.
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Affiliation(s)
- Mingkun Tong
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health , Peking University Health Science Center, Beijing, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health , Peking University Health Science Center, Beijing, China
| | - Jicheng Gong
- State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA
| | - Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health , Peking University Health Science Center, Beijing, China.
- State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
- Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China.
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Niu Z, Habre R, Yang T, Grubbs BH, Eckel SP, Toledo-Corral CM, Johnston J, Dunton GF, Lurvey N, Al-Marayati L, Lurmann F, Pavlovic N, Bastain TM, Breton CV, Farzan SF. Preconceptional and prenatal exposure to air pollutants and risk of gestational diabetes in the MADRES prospective pregnancy cohort study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100575. [PMID: 37727593 PMCID: PMC10505827 DOI: 10.1016/j.lana.2023.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023]
Abstract
Background Air pollution has been associated with gestational diabetes mellitus (GDM). We aim to investigate susceptible windows of air pollution exposure and factors determining population vulnerability. Methods We ascertained GDM status in the prospective Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort from Los Angeles, California, USA. We calculated the relative risk of GDM by exposure to ambient particulate matter (PM10; PM2.5), nitrogen dioxide (NO2), and ozone (O3) in each week from 12 weeks before to 24 weeks after conception, adjusting for potential confounders, with distributed lag models to identify susceptible exposure windows. We examined effect modification by prenatal depression, median-split pre-pregnancy BMI (ppBMI) and age. Findings Sixty (9.7%) participants were diagnosed with GDM among 617 participants (mean age: 28.2 years, SD: 5.9; 78.6% Hispanic, 11.8% non-Hispanic Black). GDM risk increased with exposure to PM2.5, PM10, and NO2 in a periconceptional window ranging from 5 weeks before to 5 weeks after conception: interquartile-range increases in PM2.5, PM10, and NO2 during this window were associated with increased GDM risk by 5.7% (95% CI: 4.6-6.8), 8.9% (8.1-9.6), and 15.0% (13.9-16.2), respectively. These sensitive windows generally widened, with greater effects, among those with prenatal depression, with age ≥28 years, or with ppBMI ≥27.5 kg/m2, than their counterparts. Interpretation Preconception and early-pregnancy are susceptible windows of air pollutants exposure that increased GDM risk. Prenatal depression, higher age, or higher ppBMI may increase one's vulnerability to air pollution-associated GDM risk. Funding National Institutes of Health, Environmental Protection Agency.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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9
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Giotta M, Bartolomeo N, Trerotoli P. A Retrospective Observational Study Using Administrative Databases to Assess the Risk of Spontaneous Abortions Related to Environmental and Socioeconomic Conditions. Life (Basel) 2023; 13:1853. [PMID: 37763257 PMCID: PMC10532634 DOI: 10.3390/life13091853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Miscarriage is one of the most frequent adverse events that occurs during pregnancy. This retrospective study aimed to verify if the environmental and socioeconomic conditions related to geographical areas where women live, and the socio-demographic and clinical factors play a role in the risk of spontaneous abortion (SA). The analyses were conducted by hospital discharge records (HDRs) from public and private hospitals in Apulia from 1 January 2021 to 31 December 2021. Women with an age over 40 years old had a major risk of SA compared with women under 18 years (OR 2.30, IC95%1.16-4.54). A reduction in the risk of SA was found for women with an endocrinological or metabolic disease (OR 0.28, 95% CI 0.19-0.41), while genetic disease greatly increases the risk (OR 9.63, IC95% 1.98-46.86). The greatest risk of spontaneous abortion was found in the province of Taranto compared to the province of Foggia (OR 2.01, 95% CI 1.52-2.64). The provinces with a higher risk of SA in the multiple comparisons were Taranto, Brindisi, and BAT. Municipalities with socioeconomic disadvantages classified as very low, low, and medium had a higher risk of SA compared to the municipalities with a high disadvantage. In conclusion, our study indicates the possible association between SA rate and environmental conditions. Additionally, the socioeconomic, clinical, and demographic factors were related to the risk of SAs.
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Affiliation(s)
- Massimo Giotta
- School of Medical Statistics and Biometry, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
- Department of Precision and Regenerative Medicine, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Nicola Bartolomeo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (N.B.); (P.T.)
| | - Paolo Trerotoli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (N.B.); (P.T.)
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10
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Younger A, Alkon A, Harknett K, Kirby MA, Elon L, Lovvorn AE, Wang J, Ye W, Diaz-Artiga A, McCracken JP, Castañaza Gonzalez A, Monroy Alarcon L, Mukeshimana A, Rosa G, Chiang M, Balakrishnan K, Garg SS, Pillarisetti A, Piedrahita R, Johnson M, Craik R, Papageorghiou AT, Toenjes A, Quinn A, Williams KN, Underhill L, Chang HH, Naeher LP, Rosenthal J, Checkley W, Peel JL, Clasen TF, Thompson LM. Effects of a LPG stove and fuel intervention on adverse maternal outcomes: A multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN). ENVIRONMENT INTERNATIONAL 2023; 178:108059. [PMID: 37413928 PMCID: PMC10445187 DOI: 10.1016/j.envint.2023.108059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023]
Abstract
Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid cooking fuels. Pregnant women (18-34 years of age; gestation confirmed by ultrasound at 9-19 weeks) were randomly assigned to an intervention (n = 1593) or control (n = 1607) arm. Intention-to-treat analyses compared outcomes between the two arms using log-binomial models. Among the 3195 pregnant women in the study, there were 10 spontaneous abortions (7 intervention, 3 control), 93 hypertensive disorders of pregnancy (47 intervention, 46 control), 11 post postpartum hemorrhage (5 intervention, 6 control) and 4 maternal deaths (3 intervention, 1 control). Compared to the control arm, the relative risk of spontaneous abortion among women randomized to the intervention was 2.32 (95% confidence interval (CI): 0.60, 8.96), hypertensive disorders of pregnancy 1.02 (95% CI: 0.68, 1.52), postpartum hemorrhage 0.83 (95% CI: 0.25, 2.71) and 2.98 (95% CI: 0.31, 28.66) for maternal mortality. In this study, we found that adverse maternal outcomes did not differ based on randomized stove type across four country research sites.
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Affiliation(s)
- Ashley Younger
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Abbey Alkon
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Kristen Harknett
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Miles A Kirby
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Lisa Elon
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amy E Lovvorn
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jiantong Wang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Wenlu Ye
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Anaité Diaz-Artiga
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - John P McCracken
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala; Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
| | | | - Libny Monroy Alarcon
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | | | - Ghislaine Rosa
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Marilu Chiang
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore MD, USA
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Sarada S Garg
- Department of Environmental Health Engineering, ICMR Center for Advanced Research on Air Quality, Climate and Health, Sri Ramachandra Institute for Higher Education and Research (Deemed University), Chennai, India
| | - Ajay Pillarisetti
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | | | | | - Rachel Craik
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Aris T Papageorghiou
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Ashley Toenjes
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Kendra N Williams
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Lindsay Underhill
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
| | - Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - William Checkley
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Thomas F Clasen
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa M Thompson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
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11
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Kumari U, Sharma RK, Keshari JR, Sinha A. Environmental Exposure: Effect on Maternal Morbidity and Mortality and Neonatal Health. Cureus 2023; 15:e38548. [PMID: 37273345 PMCID: PMC10239284 DOI: 10.7759/cureus.38548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/06/2023] Open
Abstract
Environmental factors are important causes that impair global pregnancy outcomes and are, importantly, responsible for maternal morbidity and mortality. However, apart from the direct reasons for maternal deaths, mainly obstetric and neonatal complications, such factors are ignored or given less importance. The recent surge in research on the impact of various environmental factors on pregnancy outcomes suggests the need for immediate attention to such factors and device-specific policies to counter the situation. Moreover, the recent coronavirus disease of 2019 (COVID-19) pandemic, global warming, and climate change showed a lack of preparedness to counter the impact of such events on maternal survival and safe and successful pregnancy outcomes. In the present review, we have emphasized the specific factors responsible for increased maternal and neonatal deaths and their association with specific environmental factors. Increased attention on maternal healthcare, preparedness to counter sudden environmental challenges and improvement of the conventional requirement for better maternal healthcare access and nutrition at a global level may improve the scenario.
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Affiliation(s)
- Usha Kumari
- Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | | | - J R Keshari
- Biochemistery, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Archana Sinha
- Obstetrics and Gynaecology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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12
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Roger J, Xie F, Costello J, Tang A, Liu J, Oskotsky T, Woldemariam S, Kosti I, Le B, Snyder MP, Giudice LC, Torgerson D, Shaw GM, Stevenson DK, Rajkovic A, Glymour MM, Aghaeepour N, Cakmak H, Lathi RB, Sirota M. Leveraging electronic health records to identify risk factors for recurrent pregnancy loss across two medical centers: a case-control study. RESEARCH SQUARE 2023:rs.3.rs-2631220. [PMID: 36993325 PMCID: PMC10055527 DOI: 10.21203/rs.3.rs-2631220/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Recurrent pregnancy loss (RPL), defined as 2 or more pregnancy losses, affects 5-6% of ever-pregnant individuals. Approximately half of these cases have no identifiable explanation. To generate hypotheses about RPL etiologies, we implemented a case-control study comparing the history of over 1,600 diagnoses between RPL and live-birth patients, leveraging the University of California San Francisco (UCSF) and Stanford University electronic health record databases. In total, our study included 8,496 RPL (UCSF: 3,840, Stanford: 4,656) and 53,278 Control (UCSF: 17,259, Stanford: 36,019) patients. Menstrual abnormalities and infertility-associated diagnoses were significantly positively associated with RPL in both medical centers. Age-stratified analysis revealed that the majority of RPL-associated diagnoses had higher odds ratios for patients <35 compared with 35+ patients. While Stanford results were sensitive to control for healthcare utilization, UCSF results were stable across analyses with and without utilization. Intersecting significant results between medical centers was an effective filter to identify associations that are robust across center-specific utilization patterns.
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Affiliation(s)
- Jacquelyn Roger
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Feng Xie
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University
- Department of Pediatrics, Stanford University
- Department of Biomedical Data Science, Stanford University
| | - Jean Costello
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Alice Tang
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Jay Liu
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Tomiko Oskotsky
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Sarah Woldemariam
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Idit Kosti
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | - Brian Le
- Bakar Computational Health Sciences Institute, University of California San Francisco
| | | | - Linda C. Giudice
- Department of Obstetrics and Gynecology, University of California San Francisco
| | - Dara Torgerson
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | | | | | - Aleksandar Rajkovic
- Department of Pathology, University of California San Francisco
- Institute of Human Genetics, University of California San Francisco
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Nima Aghaeepour
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University
- Department of Pediatrics, Stanford University
- Department of Biomedical Data Science, Stanford University
| | - Hakan Cakmak
- Department of Obstetrics and Gynecology, University of California San Francisco
| | - Ruth B. Lathi
- Department of Obstetrics and Gynecology, Stanford University
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California San Francisco
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13
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Nazarpour S, Ramezani Tehrani F, Valizadeh R, Amiri M. The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis. J Endocrinol Invest 2023:10.1007/s40618-023-02037-z. [PMID: 36807891 DOI: 10.1007/s40618-023-02037-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/08/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Air pollution is an environmental stimulus that may predispose pregnant women to gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted to investigate the relationship between air pollutants and GDM. METHODS PubMed, Web of Science, and Scopus were systematically searched for retrieving English articles published from January 2020 to September 2021, investigating the relationship of exposure to ambient air pollution or levels of air pollutants with GDM and related parameters, including fasting plasma glucose (FPG), insulin resistance, and impaired glucose tolerance. Heterogeneity and publication bias were evaluated using I-squared (I2), and Begg's statistics, respectively. We also performed the subgroup analysis for particulate matters (PM2.5, PM10), Ozone (O3), and sulfur dioxide (SO2) in the different exposure periods. RESULTS A total of 13 studies examining 2,826,544 patients were included in this meta-analysis. Compared to non-exposed women, exposure to PM2.5 increases the odds (likelihood of occurrence outcome) of GDM by 1.09 times (95% CI 1.06, 1.12), whereas exposure to PM10 has more effect by OR of 1.17 (95% CI 1.04, 1.32). Exposure to O3 and SO2 increases the odds of GDM by 1.10 times (95% CI 1.03, 1.18) and 1.10 times (95% CI 1.01, 1.19), respectively. CONCLUSIONS The results of the study show a relationship between air pollutants PM2.5, PM10, O3, and SO2 and the risk of GDM. Although evidence from various studies can provide insights into the linkage between maternal exposure to air pollution and GDM, more well-designed longitudinal studies are recommended for precise interpretation of the association between GDM and air pollution by adjusting all potential confounders.
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Affiliation(s)
- S Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - F Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran.
| | - R Valizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - M Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
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14
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Cheng X, Zhao L, Zhang Z, Deng C, Li C, Du Y, Shi J, Zhu M. Highly efficient, low-resistant, well-ordered PAN nanofiber membranes for air filtration. Colloids Surf A Physicochem Eng Asp 2022. [DOI: 10.1016/j.colsurfa.2022.130302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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Outdoor Air Pollution and Pregnancy Loss: a Review of Recent Literature. CURR EPIDEMIOL REP 2022. [DOI: 10.1007/s40471-022-00304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose of Review
This review summarizes recent literature about the impacts of outdoor air pollution on pregnancy loss (spontaneous abortion/miscarriage and stillbirth), identifies challenges and opportunities, and provides recommendations for actions.
Recent Findings
Both short- and long-term exposures to ubiquitous air pollutants, including fine particulate matter < 2.5 and < 10 μm, may increase pregnancy loss risk. Windows of susceptibility include the entire gestational period, especially early pregnancy, and the week before event. Vulnerable subpopulations were not consistently explored, but some evidence suggests that pregnant parents from more disadvantaged populations may be more impacted even at the same exposure level.
Summary
Given environmental conditions conductive to high air pollution exposures become more prevalent as the climate shifts, air pollution’s impacts on pregnancy is expected to become a growing public health concern. While awaiting larger preconception studies to further understand causal impacts, multi-disciplinary efforts to minimize exposures among pregnant women are warranted.
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16
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Exploring Environmental Health Inequalities: A Scientometric Analysis of Global Research Trends (1970-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127394. [PMID: 35742642 PMCID: PMC9223819 DOI: 10.3390/ijerph19127394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022]
Abstract
Environmental health inequalities (EHI), understood as differences in environmental health factors and in health outcomes caused by environmental conditions, are studied by a wide range of disciplines. This results in challenges to both synthesizing key knowledge domains of the field. This study aims to uncover the global research status and trends in EHI research, and to derive a conceptual framework for the underlying mechanisms of EHI. In total, 12,320 EHI publications were compiled from the Web of Science core collection from 1970 to 2020. Scientometric analysis was adopted to characterize the research activity, distribution, focus, and trends. Content analysis was conducted for the highlight work identified from network analysis. Keyword co-occurrence and cluster analysis were applied to identify the knowledge domain and develop the EHI framework. The results show that there has been a steady increase in numbers of EHI publications, active journals, and involved disciplines, countries, and institutions since the 2000s, with marked differences between countries in the number of published articles and active institutions. In the recent decade, environment-related disciplines have gained importance in addition to social and health sciences. This study proposes a framework to conceptualize the multi-facetted issues in EHI research referring to existing key concepts.
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Ambient Air Pollution Exposure Assessments in Fertility Studies: a Systematic Review and Guide for Reproductive Epidemiologists. CURR EPIDEMIOL REP 2022; 9:87-107. [DOI: 10.1007/s40471-022-00290-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
Purpose of Review
We reviewed the exposure assessments of ambient air pollution used in studies of fertility, fecundability, and pregnancy loss.
Recent Findings
Comprehensive literature searches were performed in the PUBMED, Web of Science, and Scopus databases. Of 168 total studies, 45 met the eligibility criteria and were included in the review. We find that 69% of fertility and pregnancy loss studies have used one-dimensional proximity models or surface monitor data, while only 35% have used the improved models, such as land-use regression models (4%), dispersion/chemical transport models (11%), or fusion models (20%). No published studies have used personal air monitors.
Summary
While air pollution exposure models have vastly improved over the past decade from a simple, one-dimensional distance or air monitor data to models that incorporate physiochemical properties leading to better predictive accuracy, precision, and increased spatiotemporal variability and resolution, the fertility literature has yet to fully incorporate these new methods. We provide descriptions of each of these air pollution exposure models and assess the strengths and limitations of each model, while summarizing the findings of the literature on ambient air pollution and fertility that apply each method.
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Zhang C, Yao N, Lu Y, Ni J, Liu X, Zhou J, Wang W, Zhang T, He Y, Huang J, Sun K, Sun Y. Ambient air pollution on fecundity and live birth in women undergoing assisted reproductive technology in the Yangtze River Delta of China. ENVIRONMENT INTERNATIONAL 2022; 162:107181. [PMID: 35303533 DOI: 10.1016/j.envint.2022.107181] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ambient air pollution has adverse effects on the reproductive system. However, inconsistent conclusions were reached from different studies with regard to air pollutants and pregnancy outcomes, especially the livebirth rate in assisted reproductive technology (ART) in different windows of exposure. METHODS A retrospective cohort study was conducted on 12,665 women who underwent first fresh or frozen embryo transfer cycle in the Yangtze River Delta of China. Daily average levels of six air pollutants in four different periods were obtained: Period 1 and 2: 90 days or one year prior to oocyte retrieval; Period 3 and 4: the day of oocyte retrieval or one year prior to oocyte retrieval to the day of serum hCG test or to the end of the pregnancy. A multiple logistic regression model was used to investigate the association between air pollutant exposure and pregnancy outcomes. Stratified analyses were conducted to explore potential modifier effects. RESULTS The one year exposure window (Period 2) before oocyte retrieval had a more evident negative association with pregnancy outcomes. Each IQR increase in ambient PM10 (OR: 0.89, 95% CI: 0.84-0.93), PM2.5 (OR: 0.82, 95% CI: 0.77-0.87), SO2 (OR: 0.87, 95% CI: 0.83-0.91) and CO (OR: 0.91, 95% CI: 0.87-0.96) was associated with a respective 11%, 18%, 13% and 9% decrease in the likelihood of live birth. In entire exposure window of Period 4, all air pollutants except for O3 were associated with a decreased likelihood of live birth. Stratified analyses showed that women undergoing frozen embryo transfer cycles, especially those with two embryos transferred, were more vulnerable to air pollutant exposure. CONCLUSION This study indicates a negative association between air pollutant exposure before oocyte retrieval and livebirth rate in ART. The adverse impact was more evident in one year exposure compared to three-month refresh cycle of the gametes. Additional protection from air pollution should be undertaken at least one year before ART, particularly for those with frozen embryo transfer cycles.
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Affiliation(s)
- Chuyue Zhang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Ning Yao
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yao Lu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Jingyi Ni
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiaohui Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Ji Zhou
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai, PR China; Shanghai Typhoon Institute, CMA, Shanghai, PR China
| | - Wangsheng Wang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Ting Zhang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yaqiong He
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Jiaan Huang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Kang Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200135, PR China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai 200135, PR China.
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19
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Zhu W, Zheng H, Liu J, Cai J, Wang G, Li Y, Shen H, Yang J, Wang X, Wu J, Nie J. The correlation between chronic exposure to particulate matter and spontaneous abortion: A meta-analysis. CHEMOSPHERE 2022; 286:131802. [PMID: 34426134 DOI: 10.1016/j.chemosphere.2021.131802] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Spontaneous abortion (SAB) brings serious physical and psychological sequelae to women and their families. Though a growing body of individual studies have suggested the possible linkage between chronic particulate matter (PM) exposure and risks of SAB, the provided results were rather contradictory. We therefore performed an evidence-based meta-analysis. METHODS We systematically searched the PubMed, EMBASE and Web of Science databases for available studies published before February 1, 2021 which reported associations between PM exposure and SAB. Corresponding models were applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies according to heterogeneity test. The GRADEpro app was used to evaluate the certainty of evidence. Sensitivity analyses and a publication bias assessment were also utilized to determine the stability of results. RESULTS Of the initial 2358 citations, 6 papers examining the chronic effects of PM exposure were deemed eligible and a total population of approximately 723,000 was observed. Pooled RR for SAB risks associated with a 10 μg/m3 increase in fine particulate matter (PM2.5) and particulate matter ≤ 10 μm in aerodynamic diameter (PM10) were 1.20 (95%CI: 1.01-1.40) and 1.09 (95%CI: 1.02-1.15), respectively. The GRADE results of PM2.5 and PM10 were both categorized as "moderate" certainty evidence. CONCLUSION Our findings revealed a significant increase of SAB hazards related with maternal PM exposure, and this study may therefore provide new evidence for personal protection to improve reproductive health.
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Affiliation(s)
- Wentao Zhu
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Huiqiu Zheng
- Department of Child and Adolescent Health and Health Education, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, Inner Mongolia, China
| | - Jieyu Liu
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Jiajie Cai
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Gechao Wang
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Yi Li
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Haochong Shen
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Jing Yang
- Department of Basic Medicine and Forensic Medicine, Baotou Medical College, Baotou, 014040, Inner Mongolia, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, Inner Mongolia, China
| | - Jing Wu
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China.
| | - Jihua Nie
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, 215123, Jiangsu, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China.
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Wesselink AK, Wang TR, Ketzel M, Mikkelsen EM, Brandt J, Khan J, Hertel O, Laursen ASD, Johannesen BR, Willis MD, Levy JI, Rothman KJ, Sørensen HT, Wise LA, Hatch EE. Air pollution and fecundability: Results from a Danish preconception cohort study. Paediatr Perinat Epidemiol 2022; 36:57-67. [PMID: 34890081 PMCID: PMC8712376 DOI: 10.1111/ppe.12832] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/24/2021] [Accepted: 10/08/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Animal and epidemiologic studies indicate that air pollution may adversely affect fertility. Epidemiologic studies have been restricted largely to couples undergoing fertility treatment or have retrospectively ascertained time-to-pregnancy among pregnant women. OBJECTIVES We examined the association between residential ambient air pollution and fecundability, the per-cycle probability of conception, in a large preconception cohort of Danish pregnancy planners. METHODS During 2007-2018, we used the Internet to recruit and follow women who were trying to conceive without the use of fertility treatment. Participants completed an online baseline questionnaire eliciting socio-demographic characteristics, lifestyle factors, and medical and reproductive histories and follow-up questionnaires every 8 weeks to ascertain pregnancy status. We determined concentrations of ambient nitrogen oxides (NOx ), nitrogen dioxide (NO2 ), carbon monoxide (CO), ozone (O3 ), particulate matter <2.5 µm (PM2.5 ) and <10 µm (PM10 ), and sulphur dioxide (SO2 ) at each participant's residential address. We calculated average exposure during the year before baseline, during each menstrual cycle over follow-up and during the entire pregnancy attempt time. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for potential confounders and co-pollutants. The analysis was restricted to the 10,183 participants who were trying to conceive for <12 cycles at study entry whose addresses could be geocoded. RESULTS During 12 months of follow-up, 73% of participants conceived. Higher concentrations of PM2.5 and PM10 were associated with small reductions in fecundability. For example, the FRs for a one interquartile range (IQR) increase in PM2.5 (IQR = 3.2 µg/m3 ) and PM10 (IQR = 5.3 µg/m3 ) during each menstrual cycle were 0.93 (95% CI: 0.87, 0.99) and 0.91 (95% CI: 0.84, 0.99), respectively. Other air pollutants were not appreciably associated with fecundability. CONCLUSIONS In this preconception cohort study of Danish women, residential exposures to PM2.5 and PM10 were associated with reduced fecundability.
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Affiliation(s)
- Amelia K. Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tanran R. Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, United Kingdom
| | - Ellen M. Mikkelsen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate, interdisciplinary Centre for Climate Change, Aarhus University, Aarhus, Denmark
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Ole Hertel
- Department of Ecoscience, Aarhus University, Denmark
| | - Anne Sofie D. Laursen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Benjamin R. Johannesen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Mary D. Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth J. Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Research Triangle Institute, Durham, NC, USA
| | - Henrik T. Sørensen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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21
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Optimizing natural fertility: a committee opinion. Fertil Steril 2021; 117:53-63. [PMID: 34815068 DOI: 10.1016/j.fertnstert.2021.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 01/08/2023]
Abstract
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples or individuals attempting conception who have no evidence of infertility. This document replaces the document of the same name previously published in 2013 (Fertil Steril 2013;100:631-7).
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Affiliation(s)
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- The American Society for Reproductive Medicine, Birmingham, Alabama
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22
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Sun S, Wang X, Ding L, Zhang Q, Li N, Sui X, Li C, Ju L, Zhao Q, Chen H, Ding R, Cao J. Association between preconceptional air pollution exposure and medical purposes for selective termination of pregnancy. ENVIRONMENTAL RESEARCH 2021; 202:111743. [PMID: 34331927 DOI: 10.1016/j.envres.2021.111743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to air pollutants is associated with adverse pregnancy outcomes. But evidence on the effects of preconceptional air pollution exposure on the risk of termination of pregnancy (TOP) caused by pregnancy losses and congenital malformations is lacking. METHODS The distributed lag nonlinear model (DLNM) was used to evaluate the impact of short-term air pollutants exposure on the risk of TOP. Stratified analyses by age (<35 years old, ≥ 35 years old) and season (warm season, cold season) were further conducted. Relative risk (RR) and 95 % confidential interval (95 % CI) were calculated for per interquartile range (IQR) increment in air pollutants during the study period. RESULTS PM2.5, PM10, and O3 exposure were significantly associated with elevated risk of TOP. The risk of TOP was associated with PM2.5 exposure from lag11 to lag15 in the single-pollutant model, and the strongest association was observed at lag13 (RR = 1.021, 95%CI:1.002-1.040). PM10 exposure from lag10 to lag15 was associated with increased TOP risk, with the corresponding peak association being at lag13 (RR = 1.020, 95%CI: 1.004-1.037). For O3, the single-day lag association appeared to be statistically significant from lag26 to lag27, with the highest RR of TOP cases being at lag27 (RR = 1.044, 95%CI: 1.005-1.084). Similar results were observed for pregnancy losses (PL). However, no significantly association between air pollution exposure and the risk of congenital malformations (CM) was found in this study. Stratified analyses showed that pregnant women with more advanced ages were more susceptible to PM2.5, PM10, and O3 exposure. The effect of PM2.5 exposure was statistically significant in cold season subgroups. CONCLUSION The findings suggest that exposure to PM2.5, PM10, and O3 before pregnancy are associated with the risk of TOP in Lu'an, China, reflecting the significance of preconceptional environmental exposure in the development of adverse pregnancy outcomes.
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Affiliation(s)
- Shu Sun
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Xiaoyu Wang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Obstetrics and Gynecology, Lu'an Hospital Affiliated to Anhui Medical University, 21 West Wanxi Road, Lu'an, China
| | - Liu Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Qi Zhang
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Na Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xinmiao Sui
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Liangliang Ju
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Qihong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Hongbo Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, 15 Yimin Road, Hefei, China.
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
| | - Jiyu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Department of Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China.
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23
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Bogan M, Al B, Kul S, Zengin S, Oktay M, Sabak M, Gümüşboğa H, Bayram H. The effects of desert dust storms, air pollution, and temperature on morbidity due to spontaneous abortions and toxemia of pregnancy: 5-year analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1733-1739. [PMID: 33829325 DOI: 10.1007/s00484-021-02127-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/07/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
Epidemiological studies have suggested an association between particulate air pollution, increased temperatures, and morbidity related to pregnancy outcomes. However, the roles of desert dust storms and climatological factors have not been fully addressed. The objectives of the present study were to investigate the association between desert dust storms, particulate matter with a diameter ≤10 μm (PM10), daily temperatures, and toxemia of pregnancy and spontaneous abortion in Gaziantep, South East Turkey. The study was conducted retrospectively at emergency department of two hospitals in Gaziantep city. Data from January 1, 2009, to March 31, 2014, were collected. Patients, who were diagnosed with toxemia of pregnancy and spontaneous abortion by radiological imaging modalities, were included in the study. Daily temperature ranges, mean temperature values, humidity, pressure, wind speed, daily PM10 levels, and records of dust storms were collected. A generalized additive regression model was designed to assess variable effects on toxemia of pregnancy and spontaneous abortion, while adjusting for possible confounding factors. Our findings demonstrated that presence of dust storms was positively associated with the toxemia of pregnancy both in outpatient admissions (OR=1.543 95% CI=1.186-2.009) and inpatient hospitalizations (OR=1.534; 95% CI=1.162-2.027). However, neither PM10 nor maximum temperature showed a marked association with spontaneous abortion or toxemia of pregnancy in our study population. Our findings suggest that desert dust storms may have an impact on the risk for adverse pregnancy outcomes such as toxemia of pregnancy. Health authorities should take necessary measures to protect pregnant women against detrimental effects of these storms.
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Affiliation(s)
- Mustafa Bogan
- Department of Emergency Medicine, School of Medicine, Düzce University, 81620, Düzce, Turkey.
| | - Behcet Al
- Emergency Department of Medicine Faculty, Gaziantep University, 27070, Gaziantep, Turkey
| | - Seval Kul
- Biostatistics Department of Medicine Faculty, Gaziantep University, 27070, Gaziantep, Turkey
| | - Suat Zengin
- Emergency Department of Medicine Faculty, Gaziantep University, 27100, Gaziantep, Turkey
| | - Murat Oktay
- Vocational High School, Hasan Kalyoncu University, 27000, Gaziantep, Turkey
| | - Mustafa Sabak
- Emergency Department of Medicine Faculty, Gaziantep University, 27705, Gaziantep, Turkey
| | - Hasan Gümüşboğa
- Emergency Department of Şehitkamil State Hospital, 27500, Gaziantep, Turkey
| | - Hasan Bayram
- Department of Pulmonary Medicine Koç University Research Center for Translational Medicine (KUTTAM), School of Medicine, Koç University, Istanbul, Turkey
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24
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Liang Z, Xu C, Liang S, Cai TJ, Yang N, Li SD, Wang WT, Li YF, Wang D, Ji AL, Zhou LX, Liang ZQ. Short-term ambient nitrogen dioxide exposure is associated with increased risk of spontaneous abortion: A hospital-based study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112633. [PMID: 34411816 DOI: 10.1016/j.ecoenv.2021.112633] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
There are increasing concerns with regard to spontaneous abortion (SAB), the loss of pregnancy without external intervention before 20 weeks of gestation, among reproductive-aged women. To date, limited evidence is available concerning the association between SAB and air pollutants, especially in developing countries. Daily baseline outpatient data for SAB from January 1, 2014, to December 31, 2018 (1826 days) were obtained in Chongqing, a metropolis of southwest China. The over-dispersed Poisson generalized additive model with control of meteorological conditions and day of week was used to estimate the short-term effects of ambient air pollution on the daily number of SAB outpatients. A total of 42,334 SAB outpatient visits for SAB were recorded. No statistically significant association was observed between SAB and CO, PM2.5, PM10, O3, and SO2. The positive association only appeared for NO2: positive associations between SAB and NO2 were observed in both single-day models (lag 0, lag 1, lag 3, and lag 4) and cumulative exposure models (lag 01, lag 03, and lag 05) and the most significant effects were observed at lag 05 (3.289%; 95% CI: 1.568%, 5.011%). Moreover, the women with higher ages (30-39 and > 39) were more sensitive than those with lower ages (18-29), and the effect estimates were more evident in cool seasons. Collectively, our results suggested that short-term NO2 exposure was associated with higher risk of SAB, especially in elder women and cool seasons, which may contribute to further understand the role of air pollution on SAB and other adverse obstetric outcomes.
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Affiliation(s)
- Zhen Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chen Xu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China; Department of Hepatobiliary Surgery, Xijing Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Shi Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China; Department of Chemistry, Brigham Young University-Idaho, Rexburg, ID, USA
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China.
| | - Neng Yang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Si-Di Li
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wen-Ting Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Zhi-Qing Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
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25
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Wang H, Li J, Liu H, Guo F, Xue T, Guan T, Li J. Association of maternal exposure to ambient particulate pollution with incident spontaneous pregnancy loss. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112653. [PMID: 34411818 DOI: 10.1016/j.ecoenv.2021.112653] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/04/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Maternal exposure to ambient fine particulate matter (PM2.5) is a potential risk factor for pregnancy loss, but the extant findings are inconsistent. One reason for the inconsistency is the difficulty of distinguishing spontaneous from induced pregnancy losses, particularly in countries with planning policies. OBJECTIVE To examine the association between maternal PM2.5 exposure and spontaneous incident pregnancy loss in China. METHODS A total of 18,513 women of reproductive age was recruited from Jiangsu Province, China, in 2007. Among them, 2451 women reported 2613 valid records of incident pregnancies from 2007 to 2010. We used Cox regression to link the outcomes (live birth, spontaneous pregnancy loss, or induced abortion) of those incident pregnancies with maternal PM2.5 exposures, assessed using well-developed estimates of historical concentrations at the county level. RESULTS Among the 2613 incident pregnancies, 69 spontaneous pregnancy losses, 596 induced abortions, and 1948 live births occurred. According to the adjusted model, each 10-μg/m3 increment in the average PM2.5 concentration during pregnancy was associated with a 43.3% (95% confidence interval, 6.6-92.5%) increased probability of spontaneous pregnancy loss. Advanced maternal age, a potential competing risk factor, weakened the association between PM2.5 and spontaneous pregnancy loss. The association was nonsignificant for unintended pregnancies. CONCLUSION Maternal PM2.5 exposure was associated significantly with incident spontaneous pregnancy loss. Our findings provide insight into the harmful effect of air pollution on human reproduction.
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Affiliation(s)
- Huiyu Wang
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jiajianghui Li
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Hengyi Liu
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Fuyu Guo
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Tao Xue
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
| | - Tianjia Guan
- Department of Health Policy, School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jiwei Li
- College of Computer Science and Technology, Zhejiang University, Hangzhou, Zhejiang 310027, China; Shannon.AI, Beijing 100080, China
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26
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Muñoz-Rodríguez A, Maciel-Ruiz JA, Salazar AM, Sordo M, Ostrosky-Wegman P, Limón-Pacheco JH, Nepomuceno-Hernández AE, Ayala-Yáñez R, Gonsebatt ME, Osorio-Yáñez C. Prenatal Particulate Matter (PM) Exposure and Natriuretic Peptides in Newborns from Mexico City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126546. [PMID: 34206994 PMCID: PMC8296353 DOI: 10.3390/ijerph18126546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The aim of this study was to assess associations between particulate matter (PM) exposure and natriuretic peptide concentrations in cord blood from newborns. (2) Methods: we conducted a cross-sectional study in Mexico City with 101 pregnant women from CIMIGEN Hospital. Atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) were measured in plasma from cord blood in 51 newborns by ELISA. We estimated PM exposure (PM2.5 and PM10) at first, second and third trimester of pregnancy. (3) Results: The median and interquartile range for ANP, BNP and CNP plasma concentrations were 66.71 (46.92-80.23), 98.23 (73.64-112.30) and 1129.11 (944.10-1452.02) pg/mL, respectively. PM2.5 and PM10 levels for the whole pregnancy period were 22.2 µg/m3 and 41.63 µg/m3, respectively. Employing multivariable linear regression models adjusted for maternal age, newborn sex, smoking before pregnancy, maternal occupation and newborns' length and height, we observed a 2.47 pg/mL (95%CI: -4.67, -0.27) decrease in BNP associated with PM2.5 exposure during second trimester. Adjusted for the same set of confounders, third trimester PM10 exposure was inversely associated with ANP concentrations (beta estimate: -0.90; 95% CI: -1.80, -0.03). Neither PM10 nor PM2.5 were associated with CNP at any trimester of pregnancy. (4) Conclusions: Prenatal exposure to particulate matter was associated with ANP and BNP decrease in newborns.
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Affiliation(s)
- Abigail Muñoz-Rodríguez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Jorge Alfonso Maciel-Ruiz
- Instituto Nacional de Cancerología (INCan), Subdirección de Investigación Básica, Ciudad de México 14080, Mexico;
| | - Ana María Salazar
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Monserrat Sordo
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Patricia Ostrosky-Wegman
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Jorge H. Limón-Pacheco
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Andrés Eduardo Nepomuceno-Hernández
- Centro de Investigación Materno Infantil del Grupo de Estudios al Nacimiento, Asociación Hispano Mexicana, Ciudad de México 09880, Mexico; (A.E.N.-H.); (R.A.-Y.)
| | - Rodrigo Ayala-Yáñez
- Centro de Investigación Materno Infantil del Grupo de Estudios al Nacimiento, Asociación Hispano Mexicana, Ciudad de México 09880, Mexico; (A.E.N.-H.); (R.A.-Y.)
| | - María Eugenia Gonsebatt
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
| | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Apartado Postal 70228, Ciudad de México 04510, Mexico; (A.M.-R.); (A.M.S.); (M.S.); (P.O.-W.); (J.H.L.-P.); (M.E.G.)
- Correspondence: ; Tel.: +55-5622-3159
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Kim JH, Choi YY, Yoo SI, Kang DR. Association between ambient air pollution and high-risk pregnancy: A 2015-2018 national population-based cohort study in Korea. ENVIRONMENTAL RESEARCH 2021; 197:110965. [PMID: 33722528 DOI: 10.1016/j.envres.2021.110965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Several studies have indicated that prenatal exposure to ambient air pollution is associated with an increased risk of gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth. However, no previous study has focused on the association between the number of pregnancy complications and exposure to ambient air pollution. OBJECTIVES To investigate the association between prenatal exposure to ambient air pollutants and the number of pregnancy complications in high-risk pregnancies. METHODS We collected data on gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth from the National Health Information Databases, provided by the Korean National Health Insurance Service.R To assess individual-level exposure to air pollutants, a spatial prediction model and area-averaging approach were used. RESULTS From 2015 to 2018, data of 789,595 high-risk pregnancies were analyzed. The ratio of gestational diabetes mellitus in the country was the highest, followed by preterm birth, hypertensive disorder during pregnancy, and stillbirth. Approximately 71.7% of pregnant women (566,143) presented with one pregnancy complication in identical pregnancies, 27.5% (216,714) presented with two, and 0.9% (6738) presented with three or more. Multiple logistic regression models with adjustments for age, residence, and income variables indicated that the risk of having two or more pregnancy complications was positively associated with the exposure to higher levels of PM10 (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.09-1.12) and PM2.5 (OR, 1.14; 95% CI, 1.12-1.15). The highest quartile presented higher odds of two or more pregnancy complications compared with the lower three quartiles of PM10, PM2.5, CO, NO2, and SO2 exposures (p < 0.001). CONCLUSION The results indicate that the risk of pregnancy complications is positively associated with the exposure to the high concentrations of PM10, PM2.5, CO, NO2, and SO2.
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Affiliation(s)
- Ju Hee Kim
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Yoon Young Choi
- Artificial Intelligence Big Data Medical Center, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea
| | - Soo-In Yoo
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea.
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Feng X, Luo J, Wang X, Xie W, Jiao J, Wu X, Fan L, Qin G. Association of exposure to ambient air pollution with ovarian reserve among women in Shanxi province of north China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 278:116868. [PMID: 33735795 DOI: 10.1016/j.envpol.2021.116868] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Air pollution has been an important risk factor for female reproductive health. However, epidemiological evidence of ambient air pollution on the predictor for ovarian reserve (antral follicle count, AFC) is deficient. We aim to comprehensively evaluate the association of long-term exposure to ambient air pollution with AFC among women of reproductive age in Shanxi of north China. 600 women with spontaneous menstrual cycle, not using controlled ovarian stimulation, were enrolled in the retrospective study. Two distinct periods of antral follicle development were designed as exposure windows. Generalized linear model was employed to estimate the change of AFC associated with exposure of atmospheric pollutants (SO2, NO2, PM10, PM2.5, CO and O3). Stratification analysis based on age (<30, ≥30 years), university degree (yes, no), years of exposure (2013-2016, 2017-2019) and duration of infertility (<2, 2-5, >5 years) along with two pollutants model were employed to further illustrate the association. We found every 10 μg/m3 increase in SO2 concentration level during the entire development stage of antral follicle was associated with a -0.01 change in AFC (95% confidence interval: -0.016, -0.002) adjusting for the confounders including age, BMI, parity and infertility diagnosis factors. The significant association of increased SO2 level with decreased AFC was particularly observed during the early transition from primary follicle to preantral follicle stage by 10 μg/m3 increase in SO2 exposure level with a -0.01 change (95% CI: -0.015, -0.002) in AFC. The negative association was pronounced among women aged ≥30 years old, and also significant in two pollutants model after adjusting the confounders. No significant associations between other air pollutants and AFC were observed. Our finding suggests that long-term exposure to air pollutant SO2 is associated with lower AFC, raising our concern that atmospheric SO2 exposure may have potential adverse impact on women ovarian reserve.
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Affiliation(s)
- Xiaoqin Feng
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, China; Department of Reproductive Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Jinhong Luo
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Xiaocheng Wang
- Department of Medical Record and Statistics, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Wolong Xie
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Jiao Jiao
- Shanxi Academy for Environmental Planning, Taiyuan, Shanxi, 030002, China
| | - Xiaohui Wu
- Shanxi Dadi Environment Investment Holdings Company, Ltd, Taiyuan, Shanxi, 030000, China
| | - Lingling Fan
- Department of Reproductive Medicine, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China
| | - Guohua Qin
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, China.
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Balaish M, Rupp JLM. Widening the Range of Trackable Environmental and Health Pollutants for Li-Garnet-Based Sensors. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2100314. [PMID: 33829564 DOI: 10.1002/adma.202100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/06/2021] [Indexed: 06/12/2023]
Abstract
Classic chemical sensors integrated in phones, vehicles, and industrial plants monitor the levels of humidity or carbonaceous/oxygen species to track environmental changes. Current projections for the next two decades indicate the strong need to increase the ability of sensors to sense a wider range of chemicals for future electronics not only to continue monitoring environmental changes but also to ensure the health and safety of humans. To achieve this goal, more chemical sensing principles and hardware must be developed. Here, a proof-of-principle for the specific electrochemistry, material selection, and design of a Li-garnet Li7 La3 Zr2 O12 (LLZO)-based electrochemical sensor is provided, targeting the highly corrosive environmental pollutant sulfur dioxide (SO2 ). This work extends the prime use of LLZO as a battery component as well as the range of trackable pollutants for potential future sensor-noses. Novel composite sensing-electrode designs using LLZO-based porous scaffolds are employed to define a high number of reaction sites, and successfully track SO2 at the dangerous levels of 0-10 ppm with close-to-theoretical SO2 sensitivity. The insights on the sensing electrochemistry, phase stability and sensing electrode/Li+ electrolyte structures provide first guidelines for future Li-garnet sensors to monitor a wider range of environmental pollutants and toxins.
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Affiliation(s)
- Moran Balaish
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
| | - Jennifer L M Rupp
- Department of Materials Science and Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA
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Shi W, Sun C, Chen Q, Ye M, Niu J, Meng Z, Bukulmez O, Chen M, Teng X. Association between ambient air pollution and pregnancy outcomes in patients undergoing in vitro fertilization in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2021; 148:106377. [PMID: 33482441 DOI: 10.1016/j.envint.2021.106377] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/13/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The effects of ambient air pollutants on adverse pregnancy outcomes have been reported. However, studies about air pollutants exposure and pregnancy outcomes in patients undergoing IVF were limited and inconclusive. To date Shanghai has been the only city in China to implement a compulsory single embryo transfer policy for all patients undergoing their first embryo transfer procedure effective from January 2019. We aimed to investigate the associations between exposure to ambient air pollutants and biochemical pregnancy and live births, and to identify potential vulnerability characteristics of patients undergoing IVF in Shanghai, China. METHODS A retrospective cohort study was conducted on 2766 infertile patients aged ≤ 45 years who underwent first fresh or frozen-thawed cleavage stage embryo transfer in the Shanghai First Maternity and Infant Hospital during April 2016 and December 2019. Daily average ambient levels of six air pollutants (PM2.5, PM10, NO2, SO2, CO and O3 max-8h) were obtained from fixed air monitors located in closest proximity to patients' residences. The cumulative average level was calculated during three different exposure periods (period1: three months before oocyte retrieval to serum hCG test; period 2: from serum hCG test to live birth outcome; period 3: from three months before oocyte retrieval to live birth). Multiple logistic regression model was performed to investigate associations between exposure to ambient air pollutants and pregnancy outcomes. Stratified analyses were conducted to explore the potential effects modifier. RESULTS The biochemical pregnancy rate and live birth rate were 54.2% and 36.4%, respectively. The ambient NO2 exposure was significantly associated with a 14% lower pregnancy rate during period 1 (aOR = 0.86, 95%CI: 0.75-0.99). The ambient PM10 was related to significantly increased risk of lowering live birth rate among the patients during period 3 [aOR = 0.88(0.79-0.99)]. Stratified analysis showed that ambient PM10 was also significantly associated with a reduced pregnancy rate (aOR = 0.82, 95% CI: 0.69-0.97) in patients who underwent single embryo transfer during period 1. Subjects who underwent single embryo transfer also had a decreased likelihood of a live birth when exposed to ambient SO2 and O3 during period 3 [aOR = 0.74(0.57-0.95), and 0.92 (0.83-0.98), respectively]. Moreover, O3 exposure was associated with decreased live birth rates in patients living in non-urban areas. Sensitivity analyses indicated robust negative association between PM10 exposure and live birth outcomes. CONCLUSIONS Our study suggested that exposure to ambient air pollutants, in particular NO2 and PM10, was associated with an increased risk of lower rates of pregnancy and live birth respectively in patients undergoing IVF. Stratified analyses indicated that ambient SO2 and O3 levels were related to adverse pregnancy outcomes in some subgroups of IVF patients in this study. Notably, patients who underwent single embryo transfer were more susceptible to ambient air pollution exposure. Thus, prospective cohort studies are needed to investigate the underlying mechanisms and the susceptibility windows for women undergoing IVF treatment.
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Affiliation(s)
- Wenming Shi
- Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 201204 Shanghai, China
| | - Chunyan Sun
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Qiaoyu Chen
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Mingming Ye
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Jianing Niu
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Zhenzhen Meng
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Orhan Bukulmez
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Miaoxin Chen
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China.
| | - Xiaoming Teng
- Centre for Assisted Reproduction, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China; School of Life Sciences and Technology, Tongji University, Shanghai 200092, China.
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Hehua Z, Yang X, Qing C, Shanyan G, Yuhong Z. Dietary patterns and associations between air pollution and gestational diabetes mellitus. ENVIRONMENT INTERNATIONAL 2021; 147:106347. [PMID: 33385926 DOI: 10.1016/j.envint.2020.106347] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
The prevalence of gestational diabetes mellitus (GDM) has been increasing worldwide. Dietary patterns and air pollution are closely related to the occurrence of GDM. No previous study has explored the interaction effect of air pollution exposure and dietary patterns on GDM. We explored the interaction effect between main dietary patterns and pre-pregnancy exposure to air pollution on the development of GDM based on a prospective birth cohort in Northeast China. A total of 2244 participants were included in this study. Factor analysis was used to identify dietary patterns. We found that long-term exposure to nitrogen dioxide (NO2) and carbon monoxide (CO) before pregnancy was significantly associated with an increased risk of GDM; the animal foods pattern significantly modified these associations. The sub-group analysis showed that compared with a lower intake in the animal foods pattern (NO2, odds ratio [OR] = 1.07, 95% confidence interval [CI]: 0.84, 1.35; CO, OR = 1.05, 95% CI: 0.81, 1.34), higher intake in the animal foods pattern (NO2, OR = 1.41, 95% CI: 1.09, 1.83; CO, OR = 1.36, 95% CI: 1.05, 1.76) before pregnancy increased the hazardous effects of NO2 and CO on GDM development. The intake of animal blood, animal organs, preserved eggs, and processed meat products in animal food pattern could all aggravate the effect of exposure to air pollution due to NO2 and CO on GDM. Our study demonstrated that there was a significant interaction effect between animal foods pattern and exposure to air pollution on GDM. These results provide further scientific evidence of the associations among air pollution, dietary intake, and GDM, and may help as well as the prevention of GDM.
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Affiliation(s)
- Zhang Hehua
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Xia Yang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province 110004, China
| | - Chang Qing
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Gao Shanyan
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province 110004, China
| | - Zhao Yuhong
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province 110004, China.
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Blavier F, Faron G, Cools W, Blockeel C, Santos-Ribeiro S, Done E, Ranisavljevic N, Rayssiguier R, Fuchs F, Gucciardo L. Corpus luteum score, a simple Doppler examination to prognose early pregnancies. Eur J Obstet Gynecol Reprod Biol 2021; 258:324-331. [PMID: 33524776 DOI: 10.1016/j.ejogrb.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/04/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In early pregnancies, miscarriages and inconclusive ultrasound scans considering location and viability are very common. In several previous studies, serum progesterone levels predicted viability of pregnancy and, in recent ones, failed Pregnancies of Unknown Location (PUL), completion of miscarriage and complications. Corpus luteum, secreting progesterone in early pregnancy, was less studied. Some publications showed correlations between corpus luteum aspects and diagnosis of miscarriage but it was not evaluated for other outcomes in early pregnancy, such as failed PUL, completion of miscarriage or complications. We aimed to assess if Doppler examination of corpus luteum could also predict all these outcomes: failed PUL, diagnosis and completion of miscarriages and complications. STUDY DESIGN A single operator prospectively described and/or collected pictures of Doppler signal in the wall of the corpus luteum at most consultations in our early pregnancy unit and established a three-level score. All suspected or confirmed non-viable pregnancies with this score or/and serum progesterone levels were registered retrospectively. With logistic regressions, AIC/BIC, likelihood ratios, ROC curves, Mann-Whitney and Fisher exact tests, we evaluated the ability of the score, alone, to predict failed PUL, diagnosis and completion of miscarriages and the complications, and, combined, to improve previously published predictions. RESULTS From 277 included pregnancies, 186 (67.1 %) miscarried. Of these, 159/186 (85.5 %) fully evacuated without surgery: 114/186 (61.3 %) within 20 days after the first diagnosis and 45/186 (24.2 %) after more than 20 days. Twenty-seven patients (14.5 %) underwent surgical evacuation, including ten complications, five haemorrhages and five suspected infections. Logistic regression correlated strongly the corpus luteum score with failed PUL (p < 0.0001) and miscarriages (p < 0.0001). Moreover, rates of complications and swift non-surgical completions of miscarriage were respectively 0 % and 92 % with scores of 0, versus 6 % and 44 % with scores of 1, versus 16 % and 0 % with scores of 2. Combined with serum progesterone levels, this score improved most predictions. Adding parity or history of miscarriage in predictive models even increased these performances. CONCLUSIONS Corpus luteum score, alone, can predict failed PUL, diagnosis and completion of miscarriages and their complications. Combining this score with other factors (mainly serum progesterone levels) improves most predictions.
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Affiliation(s)
- Frederic Blavier
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium; Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France.
| | - Gilles Faron
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Wilfried Cools
- Interfaculty Centre for Data Processing and Statistics, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Christophe Blockeel
- Centre for Reproductive Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | | | - Elisa Done
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
| | - Noemie Ranisavljevic
- ART-PGD Department, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Romy Rayssiguier
- Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Florent Fuchs
- Department of Obstetrics and Prenatal Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Leonardo Gucciardo
- Department of Obstetrics and Prenatal Medicine, UZ Brussel University Hospital, VUB, Brussels, Belgium
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Xue T, Guan T, Geng G, Zhang Q, Zhao Y, Zhu T. Estimation of pregnancy losses attributable to exposure to ambient fine particles in south Asia: an epidemiological case-control study. Lancet Planet Health 2021; 5:e15-e24. [PMID: 33421406 DOI: 10.1016/s2542-5196(20)30268-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Maternal exposure to ambient particulate matter (PM2·5) is associated with pregnancy loss (ie, stillbirth and miscarriage). South Asia has the highest burden of pregnancy loss globally and is one of the most PM2·5 polluted regions in the world. However, knowledge of the relevant exposure-response function for mothers is insufficient. METHODS In this epidemiological case-control study, we collected data from Demographic and Health Surveys from India, Pakistan, and Bangladesh for the period 1998-2016 for women who reported at least one pregnancy loss and one or more livebirths. We assessed ambient exposure during gestation with satellite-based PM2·5 measurements for the period. To derive the exposure-response function, we did a self-compared case-control study in which each case of pregnancy loss was compared with a successful livebirth control or controls by the same mother. Using the estimated exposure-response function, we quantified pregnancy losses attributable to PM2·5 in the region for the period 2000-16 using a standard risk assessment approach. FINDINGS We assessed data for 34 197 mothers, who had at least one pregnancy loss and one or more livebirth, of whom 26 282 (76·9%) were from India, 4228 (12·4%) were from Pakistan, and 3687 (10·8%) were from Bangladesh. The 34 197 cases of pregnancy loss were matched with 76 282 livebirth controls. The mean level of PM2·5 exposure was 56·00 μg/m3 (SD 30·82) for cases and 54·57 μg/m3 (31·73) for controls. After adjustment for maternal age, non-linear terms for temperature and humidity, seasonal variation, and long-term trends, each 10 μg/m3 increment in PM2·5 was associated with an odds ratio for pregnancy loss of 1·03 (95% CI 1·02-1·05). According to the estimated non-linear exposure-response function by age and urban residence versus rural residence, for the period 2000-16, an estimated 349 681 (95% CI 152 932-489 493) pregnancy losses per year were attributed to ambient air exposure of more than 40 μg/m3 (the annual PM2·5 standard of India), accounting for 7·1% (95% CI 3·3-31·2) of the total annual pregnancy loss burden in south Asia for this period. However, our estimates could be biased because of the limitations of the data (eg, misclassification of induced and spontaneous pregnancy losses). INTERPRETATION Our findings add to epidemiological evidence of the association between pregnancy loss and PM2·5. Suboptimal air quality contributes to a considerable fraction of total pregnancy loss in south Asia. Controlling PM2·5 pollution will promote maternal health in south Asia. FUNDING Chinese Natural Science Foundation and Ministry of Science and Technology of China.
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Affiliation(s)
- Tao Xue
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Peking University, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
| | - Tianjia Guan
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guannan Geng
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, China
| | - Qiang Zhang
- Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yong Zhao
- College of Liberal Arts and Sciences, University of Connecticut, Storrs, CT, USA
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Science and Engineering, Peking University, Beijing, China.
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Gaskins AJ, Mínguez-Alarcón L, Williams PL, Chavarro JE, Schwartz JD, Kloog I, Souter I, Hauser R, Laden F. Ambient air pollution and risk of pregnancy loss among women undergoing assisted reproduction. ENVIRONMENTAL RESEARCH 2020; 191:110201. [PMID: 32937174 PMCID: PMC7658021 DOI: 10.1016/j.envres.2020.110201] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 05/05/2023]
Abstract
Accumulating evidence suggests that air pollution increases pregnancy loss; however, most previous studies have focused on case identification from medical records, which may underrepresent early pregnancy losses. Our objective was to investigate the association between acute and chronic exposure to ambient air pollution and time to pregnancy loss among women undergoing assisted reproductive technologies (ART) who are closely followed throughout early pregnancy. We included 275 women (345 human chorionic gonadotropin (hCG)-confirmed pregnancies) undergoing ART at a New England academic fertility center. We estimated daily nitrogen dioxide (NO2), ozone (O3), fine particulate matter <2.5 μm (PM2.5), and black carbon (BC) exposures using validated spatiotemporal models estimated from first positive hCG test until day of failure or live birth. Air pollution exposures were averaged over the past week and the whole pregnancy. Multivariable Cox proportional hazards models were used to estimate the hazards ratio (HR) for pregnancy loss for an interquartile range (IQR) increase in pollutant exposure. We tested for violation of proportional hazards by considering an interaction between time (in days) since positive hCG (<30 days vs. ≥30 days) and air pollution. The incidence of pregnancy loss was 29 per 100 confirmed pregnancies (n = 99). Among pregnancies not resulting in live birth, the median (IQR) time to loss was 21 (11, 30) days following positive hCG. Average past week exposures to NO2, O3, PM2.5, and BC were not associated with time to pregnancy loss. Exposure throughout pregnancy to NO2 was not associated with pregnancy loss; however, there was a statistically significant interaction with time (p-for-interaction<0.001). Specifically, an IQR increase in exposure to NO2 was positively associated with pregnancy loss after 30 days (HR = 1.34, 95% CI: 1.13, 1.58), but not in the first 30 days after positive hCG (HR = 0.83, 95% CI: 0.57, 1.20). Overall pregnancy exposure to O3, PM2.5, and BC were not associated with pregnancy loss regardless of timing. Models evaluating joint effects of all pollutants yielded similar findings. In conclusion, acute and chronic exposure to NO2, O3, PM2.5, and BC were not associated with risk of pregnancy loss; however, higher exposure to NO2 throughout pregnancy was associated with increased risk of loss 30 days after positive hCG. In this cohort, later pregnancy losses appeared more susceptible to the detrimental effects of air pollution exposure.
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Affiliation(s)
- Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Itai Kloog
- Environmental Medicine & Public Health, Mount Sinai, New York City, NY, USA
| | - Irene Souter
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Agarwal A, Panner Selvam MK, Baskaran S, Finelli R, Leisegang K, Barbăroșie C, Pushparaj PN, Robert KA, Ambar R, Iovine C, Durairajanayagam D, Henkel R. A scientometric analysis of research publications on male infertility and assisted reproductive technology. Andrologia 2020; 53:e13842. [PMID: 33236365 DOI: 10.1111/and.13842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/21/2022] Open
Abstract
Assisted reproductive technologies (ART) are considered as one of the primary management options to address severe male factor infertility. The purpose of this study was to identify the research trends in the field of male infertility and ART over the past 20 years (2000-2019) by analysing scientometric data (the number of publications per year, authors, author affiliations, journals, countries, type of documents, subject area and number of citations) retrieved using the Scopus database. We used VOS viewer software to generate a network map on international collaborations as well as a heat map of the top scientists in this field. Our results revealed a total of 2,148 publications during this period with Cleveland Clinic Foundation contributing the most (n = 69). The current scientometric analysis showed that the research trend on ART has been stable over the past two decades. Further in-depth analysis revealed that density gradient centrifugation (46%) and intracytoplasmic sperm injection (59.2%) are the most reported techniques for sperm separation and ART, respectively. Additionally, azoospermia was the most studied clinical scenario (60.6%), with majority of articles reporting pregnancy rate (47.25%) as the primary reproductive outcome for ART. This study provides insight into the current focus of research in the area of male infertility and ART as well as the areas that require further research in future.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Cătălina Barbăroșie
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | | | - Kathy Amy Robert
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rafael Ambar
- Department of Urology, Sexual and Reproductive Medicine, Faculdade de Medicina do ABC, Santo André, Brazil
| | - Concetta Iovine
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
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Wang B, Hong W, Sheng Q, Wu Z, Li L, Li X. Nitrogen dioxide exposure during pregnancy and risk of spontaneous abortion: a case-control study in China. J Matern Fetal Neonatal Med 2020; 35:3700-3706. [PMID: 33108913 DOI: 10.1080/14767058.2020.1837772] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Evidence on the relationship between prenatal exposure to NO2 and CO and spontaneous abortion (SAB) is insufficient. We investigated whether there is an association between maternal exposure to nitrogen dioxide (NO2) and carbon monoxide (CO) before and during pregnancy and SAB. METHODS We conducted a case-control study using medical records of 2445 pregnant women who admitted for abortion prior to 20 weeks of gestational age from January 2014 to December 2019 at a tertiary-care hospital in Shanghai, China. Of the 2445 participants, 1075 were SAB cases and 1370 were healthy controls (underwent elective abortions). Maternal exposure to NO2 and CO before and during pregnancy was estimated using daily air pollution concentration data. Multivariable logistic regression models were constructed to quantify the relationships between maternal exposure to NO2 or CO and the risk of SAB while controlling for potential confounders. RESULTS NO2 exposure levels during pregnancy were significantly higher in SAB cases than in healthy controls (42.26 vs. 40.67, p < .01). NO2 exposure during pregnancy was positively associated with the risk of SAB. An interquartile range (16 μg/m3) increase in NO2 exposure was associated with 68% increase in the odds of SAB (OR = 1.68, 95% CI, 1.28, 2.21). Analyses of associations by quartile of NO2 exposure showed that elevated NO2 exposure during pregnancy was associated with increased odds of SAB in linear dose-response manners. Compared with the lowest quartile of NO2 exposure, the odds of SAB in the fourth quartile of NO2 exposure increased 61% (OR = 1.61, 95% CI, 1.03-2.53). No associations of CO exposure with SAB risk were observed. CONCLUSIONS Our study suggested that exposure to NO2 during early pregnancy was associated with increased risk of SAB. Further studies are needed to confirm our results and explore the potential biological mechanism underlying these associations.
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Affiliation(s)
- Beiying Wang
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Wei Hong
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Qingjing Sheng
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Zhiping Wu
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Li Li
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Xiaocui Li
- Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, PR China
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Acrocentric Chromosome Polymorphic Variants on Chinese Female Have Possible Association with Unexplained Recurrent Pregnancy Loss. Reprod Sci 2020; 28:575-584. [PMID: 33025528 DOI: 10.1007/s43032-020-00332-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
Recurrent pregnancy loss (RPL) occurs frequently in Chinese patients, but the causes for 40-50% RPL remain unexplained. This study aims to explore possible association between recurrent pregnancy loss and chromosome polymorphism. We performed a retrospective cohort study including a total number of 2967 Chinese patients from January in 2013 to December in 2019.These participants were divided into two groups: group I (RPL group) and group II (control group). Group I included 1791 patients who underwent RPL. Group II included 1176 individuals who underwent primary infertility. Their chromosome karyotype analyses were performed by Giemsa banding protocol. Pearson chi-squared test and Fisher's exact test were employed to evaluate the difference in frequency of chromosomal polymorphic variations between both groups. Chromosomal polymorphism occurred more frequently in RPL group compared with control group, the differences for 9qh+, inv(9), and Yqh+ between both groups were (χ2 = 6.697, p = 0.01), (χ2 = 6.242, p = 0.012), and (χ2 = 4.587, p = 0.032), respectively. The most significant difference of chromosomal polymorphism karyotype between RPL group and control group was found for acrocentric chromosome (D/G group) variants (χ2 = 30.7, p < 0.001). Moreover, the difference in frequency of D/G group variants between women and men in RPL group was remarkably significant (χ2 = 55.3, p < 0.001), and furthermore, D/G group variants occurred more frequently among women in RPL group than women in control group (χ2 = 44.3, p < 0.001). We found that acrocentric chromosomal polymorphism occurred preferentially on Chinese women with RPL. The fascinating finding provides us novel insight into the potential association of higher frequency of acrocentric chromosomal variations on Chinese women with unexplained RPL.
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Boulet SL, Zhou Y, Shriber J, Kissin DM, Strosnider H, Shin M. Ambient air pollution and in vitro fertilization treatment outcomes. Hum Reprod 2020; 34:2036-2043. [PMID: 31504508 PMCID: PMC10088473 DOI: 10.1093/humrep/dez128] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 06/14/2019] [Accepted: 06/21/2019] [Indexed: 01/08/2023] Open
Abstract
STUDY QUESTION Is air pollution associated with IVF treatment outcomes in the USA? SUMMARY ANSWER We did not find clear evidence of a meaningful association between reproductive outcomes and average daily concentrations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) and ozone (O3). WHAT IS KNOWN ALREADY Maternal exposure to air pollution such as PM2.5, nitrogen oxides, carbon monoxide or O3 may increase risks for adverse perinatal outcomes. Findings from the few studies using data from IVF populations to investigate associations between specific pollutants and treatment outcomes are inconclusive. STUDY DESIGN, SIZE AND DURATION Retrospective cohort study of 253 528 non-cancelled fresh, autologous IVF cycles including 230 243 fresh, autologous IVF cycles with a transfer of ≥1 embryo was performed between 2010 and 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS We linked 2010-2012 National ART Surveillance System data for fresh, autologous IVF cycles with the ambient air pollution data generated using a Bayesian fusion model available through the Centers for Disease Control and Prevention's Environmental Public Health Tracking Network. We calculated county-level average daily PM2.5 and O3 concentrations for three time periods: cycle start to oocyte retrieval (T1), oocyte retrieval to embryo transfer (T2) and embryo transfer +14 days (T3). Multivariable predicted marginal proportions from logistic and log-linear regression models were used to estimate adjusted risk ratios (aRR) and 95% CI for the association between reproductive outcomes (implantation rate, pregnancy and live birth) and interquartile increases in PM2.5 and O3. The multipollutant models were also adjusted for patients and treatment characteristics and accounted for clustering by clinic and county of residence. MAIN RESULTS AND THE ROLE OF CHANCE For all exposure periods, O3 was weakly positively associated with implantation (aRR 1.01, 95% CI 1.001-1.02 for T1; aRR 1.01, 95% CI 1.001-1.02 for T2 and aRR 1.01, 95% CI 1.001-1.02 for T3) and live birth (aRR 1.01, 95% CI 1.002-1.02 for T1; aRR 1.01, 95% CI 1.004-1.02 for T2 and aRR 1.02, 95% CI 1.004-1.03 for T3). PM2.5 was not associated with any of the reproductive outcomes assessed. LIMITATIONS, REASONS FOR CAUTION The main limitation of this study is the use of aggregated air pollution data as proxies for individual exposure. The weak positive associations found in this study might be related to confounding by factors that we were unable to assess and may not reflect clinically meaningful differences. WIDER IMPLICATIONS OF THE FINDINGS More research is needed to assess the impact of air pollution on reproductive function. STUDY FUNDING/COMPETING INTEREST(S) None.
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Affiliation(s)
- S L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Y Zhou
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J Shriber
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D M Kissin
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA.,Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Strosnider
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M Shin
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Gaskins AJ, Hart JE. The use of personal and indoor air pollution monitors in reproductive epidemiology studies. Paediatr Perinat Epidemiol 2020; 34:513-521. [PMID: 31600011 PMCID: PMC7145751 DOI: 10.1111/ppe.12599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/05/2019] [Accepted: 09/10/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Personal and indoor air pollution monitors represent two ways to assess acute air pollution exposures; however, few reproductive epidemiology studies have incorporated these tools. OBJECTIVE To provide an overview of the unique challenges and opportunities that arise when measuring acute exposure to air pollution in two ongoing reproductive epidemiology studies. METHODS The Air Pollution, In Vitro Fertilization (IVF), and Reproductive Outcomes (AIR) Study recruits women undergoing IVF to wear a personal particulate matter (PM) air pollution monitor (AirBeam2©) for the 72-hour period following the start of controlled ovarian stimulation. The Reproductive Effects of Chemicals and Air Pollutants (RECAP) Study recruits men across the United States to place an air pollution monitor (emmET) in their home for 3 months, use a smartphone application, and provide a semen sample. We highlight the key issues identified in implementing exposure assessment for both studies. RESULTS The main advantages of using the AirBeam2© personal monitor are as follows: (a) the low cost, (b) the ability to collect multiple size fractions of PM data every second, (c) the portability, (d) its capability to track GPS location, and (e) the ability for the participant to observe their real-time exposure information. The limited battery life, incompatibility with iOS-based smartphones, and frequent connection issues that arise between the AirBeam2© and smartphone are the main disadvantages. The main advantages of the emmET are the ability to measure multiple air pollutants at a high level of accuracy, collect data for a long period of time without burdening the participant, and ship monitors to participants around the country without the need for in-person set-up by trained technicians; however, the monitor only measures the indoor home environment. CONCLUSIONS Novel methods can be utilised to characterise short-term air pollution exposure in reproductive epidemiology studies and represent an exciting area for future research.
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Affiliation(s)
- Audrey J. Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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Ye M, Shi W, Hao Y, Zhang L, Chen S, Wang L, He X, Li S, Xu C. Associations of mitochondrial DNA copy number and deletion rate with early pregnancy loss. Mitochondrion 2020; 55:48-53. [PMID: 32738357 DOI: 10.1016/j.mito.2020.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/01/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Abstract
Early pregnancy loss (EPL) is a common event worldwide. Previous studies show that mitochondrial DNA (mtDNA) copy number (CN) is associated with semen parameters and preimplantation embryo viability, indicating the predictive potential of mtDNA CN for ongoing pregnancy outcomes. However, no relevant study has assessed the relationship between mtDNA CN and EPL. Thus, we aimed to determine whether mtDNA CN and mtDNA 4977-bp deletion rate (DR) in chorionic villous tissue are associated with EPL. Chorionic villous tissue total DNA was extracted from 75 EPL cases and 75 healthy controls. Chromosomal analysis was conducted using copy number variation (CNV) sequencing. The mtDNA CN and DR were measured in samples without pathogenic CNVs. The association between mtDNA CN or DR and EPL risk were estimated using logistic regression. The EPL group had a significantly different mtDNA CN (P < 0.001) and DR (P = 0.005) compared to the control group. Both biomarkers were independent risk factors for EPL (CN odds ratio 1.71, 95% confidence interval 1.17 to 2.49, P = 0.005; DR odds ratio 1.07, 95% confidence interval 1.02 to 1.12, P = 0.006). These results suggest that higher mtDNA CN and DR levels are strongly associated with EPL and represent independent risk factors for EPL. Further studies validating these findings and exploring the underlying biological mechanisms are warranted.
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Affiliation(s)
- Mujin Ye
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Weihui Shi
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Yanhui Hao
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Lanlan Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Songchang Chen
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Liya Wang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaoying He
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Shuyuan Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Chenming Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
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Ha S, Nobles C, Kanner J, Sherman S, Cho SH, Perkins N, Williams A, Grobman W, Biggio J, Subramaniam A, Ouidir M, Chen Z, Mendola P. Air Pollution Exposure Monitoring among Pregnant Women with and without Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134888. [PMID: 32645870 PMCID: PMC7369909 DOI: 10.3390/ijerph17134888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study (2015–2018) were enrolled during pregnancy and monitored for 2–4 days. Daily pollutants were measured using personal air monitors, indoor air monitors, and nearest Environmental Protection Agency’s stationary monitors based on GPS tracking and home address. Results: Personal-monitor measurements of PM2.5, ozone, and NO2 did not vary by asthma status but exposure profiles significantly differed by assessment methods. EPA stationary monitor-based methods appeared to underestimate PM2.5 and temperature exposure and overestimate ozone and NO2 exposure. Higher indoor-monitored PM2.5 exposures were associated with smoking and the use of gas appliances. The proportion of waking-time during which personal monitors were worn was ~56%. Lower compliance was associated with exercise, smoking, being around a smoker, and the use of a prescription drug. Conclusions: Exposure did not vary by asthma status but was influenced by daily activities and assessment methods. Personal monitors may better capture exposures but non-compliance merits attention. Meanwhile, larger monitoring studies are warranted to further understand exposure profiles and the health effects of air pollution during pregnancy.
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Affiliation(s)
- Sandie Ha
- Department of Public Health, Health Sciences Research Institute, College of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
- Correspondence: ; Tel.: +1-209-228-3615
| | - Carrie Nobles
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Jenna Kanner
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | | | - Seung-Hyun Cho
- RTI International, Research Triangle Park, NC 27709, USA;
| | - Neil Perkins
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Andrew Williams
- School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA;
| | - William Grobman
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | | | - Akila Subramaniam
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Marion Ouidir
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
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Oghenetega OB, Ana GREE, Okunlola MA, Ojengbede OA. Miscarriage, stillbirth, and infant death in an oil-polluted region of the Niger Delta, Nigeria: A retrospective cohort study. Int J Gynaecol Obstet 2020; 150:361-367. [PMID: 32503082 DOI: 10.1002/ijgo.13259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/06/2020] [Accepted: 06/02/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the association between oil pollution and miscarriage, stillbirth, and infant death in the Niger Delta region of Nigeria. METHODS A retrospective cohort study was undertaken of pregnant women (aged 18-45 years) who attended selected health facilities in regions with high and low exposure to oil pollution from May 14, 2018, to September 27, 2018. A multistage sampling technique was used to randomly select a representative of women with high and low exposure to oil pollution. An interviewer-administered questionnaire was used for data collection. Bivariate and multivariable logistic regression analyses were employed to adjust for confounding factors of miscarriage, stillbirth, and infant death. RESULTS In total, 1564 pregnant women were included in the study. Women with high exposure to oil pollution were more likely to experience stillbirth (odds ratio [OR] 1.806; 95% confidence interval [CI] 1.177-2.770) and infant death (OR 2.162; 95% CI 1.409-3.317). However, after adjusting for potential confounders, only infant death was associated with high exposure (adjusted OR 1.843; 95% CI 1.146-2.962). No association was found between miscarriage and high exposure to oil pollution. CONCLUSION Women with high exposure to oil pollution are at higher risk of infant death.
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Affiliation(s)
- Onome B Oghenetega
- Department of Obstetrics and Gynecology, College of Medicine, Pan African University Life and Earth Sciences Institutes, University of Ibadan, Ibadan, Nigeria
| | - Godson R E E Ana
- Department of Environmental Health, Faculty of Public Health, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Michael A Okunlola
- Department of Obstetrics and Gynecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Oladosu A Ojengbede
- Department of Obstetrics and Gynecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria
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Segal TR, Giudice LC. Before the beginning: environmental exposures and reproductive and obstetrical outcomes. Fertil Steril 2020; 112:613-621. [PMID: 31561863 DOI: 10.1016/j.fertnstert.2019.08.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 12/21/2022]
Abstract
There is growing consensus that preconception exposure to environmental toxins can adversely affect fertility, pregnancy, and fetal development, which may persist into the neonatal and adult periods and potentially have multigenerational effects. Here we review current data on preconception and prenatal exposure to several chemicals, including heavy metals, endocrine-disrupting chemicals, pesticides, and air pollution, and their associated obstetrical and reproductive health effects. Reproductive endocrinologists and affiliated health care providers have a unique opportunity to counsel patients before they get pregnant to minimize exposure to hazardous chemicals with the goal to improve reproductive outcomes and assure a healthy lifestyle overall. We provide practical tools and some publicly available resources for reproductive health professionals to assess a patient's risks and ways to reduce chemical and air pollution exposures during the critical preconception and prenatal periods.
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Affiliation(s)
- Thalia R Segal
- Center for Reproductive Health, University of California, San Francisco, California.
| | - Linda C Giudice
- Center for Reproductive Health, University of California, San Francisco, California
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Wang B, Xu S, Lu X, Ma L, Gao L, Zhang SY, Li R, Fu L, Wang H, Sun GP, Xu DX. Reactive oxygen species-mediated cellular genotoxic stress is involved in 1-nitropyrene-induced trophoblast cycle arrest and fetal growth restriction. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 260:113984. [PMID: 32041019 DOI: 10.1016/j.envpol.2020.113984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
1-nitropyrene (1-NP) is a key component of diesel exhaust-sourced fine particulate matter (PM2.5). Our recent study demonstrated that gestational 1-NP exposure caused placental proliferation inhibition and fetal intrauterine growth restriction (IUGR). This study aimed to investigate the role of genotoxic stress on 1-NP-induced placental proliferation inhibition and fetal IUGR. Human trophoblasts were exposed to 1-NP (10 μM). Growth index was reduced and PCNA was downregulated in 1-NP-exposed placental trophoblasts. More than 90% of 1-NP-exposed trophoblasts were arrested in either G0/G1 or G2/M phases. CDK1 and cyclin B, two G2/M cycle-related proteins, and CDK2, a G0/G1 cycle-related protein, were reduced in 1-NP-exposed trophoblasts. Phosphorylated Rb, a downstream molecule of CDK2, was inhibited in 1-NP-exposed trophoblasts. Moreover, DNA double-strand break was observed and γ-H2AX, another indicator of DNA double-strand break, was upregulated in 1-NP-exposed trophoblasts. Phosphorylated ATM, a key molecule of genotoxic stress, and its downstream molecule Chk2 were elevated. By contrast, Cdc25A, a downstream target of Chk2, was reduced in 1-NP-exposed trophoblasts. Phenyl-N-t-butylnitrone (PBN), a free radical scavenger, inhibited 1-NP-induced genotoxic stress and trophoblast cycle arrest. Animal experiment showed that N-acetylcysteine (NAC), an antioxidant, rescued 1-NP-induced placental proliferation inhibition and fetal IUGR in mice. These results provide evidence that reactive oxygen species (ROS)-mediated cellular genotoxic stress partially contributes to 1-NP-induced placental proliferation inhibition and fetal IUGR.
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Affiliation(s)
- Bo Wang
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Shen Xu
- First Affiliated Hospital, Anhui Medical University, Hefei, 230032, China
| | - Xue Lu
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Li Ma
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Lan Gao
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Shan-Yu Zhang
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Ran Li
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Lin Fu
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Hua Wang
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Guo-Ping Sun
- First Affiliated Hospital, Anhui Medical University, Hefei, 230032, China
| | - De-Xiang Xu
- Department of Toxicology & Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China.
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Serum progesterone levels could predict diagnosis, completion and complications of miscarriage. J Gynecol Obstet Hum Reprod 2020; 49:101721. [DOI: 10.1016/j.jogoh.2020.101721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/16/2019] [Accepted: 02/16/2020] [Indexed: 11/19/2022]
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Liang Z, Xu C, Fan YN, Liang ZQ, Kan HD, Chen RJ, Yao CY, Liu XL, Lang HB, Lei J, Zhao YS, Li YF, Ji AL, Cai TJ. Association between air pollution and menstrual disorder outpatient visits: A time-series analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 192:110283. [PMID: 32061980 DOI: 10.1016/j.ecoenv.2020.110283] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 06/10/2023]
Abstract
Menstrual disorders are common diseases among reproductive-aged women with increasing concerns. Until now, there have been limited studies about the association between menstrual disorders and air pollution. This study aimed to investigate the association between short-term (concurrent day and within 1 week prior) ambient air pollution exposure and menstrual disorder outpatient visits in Xi'an, a metropolis in northwestern China. Daily baseline outpatient data of menstrual disorders from January 1, 2010 to February 18, 2016 (2239 days) were obtained. An over-dispersed Poisson generalized additive model was applied to discover the relationship between short-term air pollution exposure and the number of menstrual disorder outpatient visits by adjusting the day of the week and weather conditions. A total of 51,893 outpatient visits for menstrual disorders were recorded. A 10 μg/m3 increase of PM10 and NO2 concentrations corresponded to 0.236% (95% Cl: 0.075%, 0.397%) and 2.173% (95% Cl: 0.990%, 3.357%) elevations in outpatient-visits for menstrual disorders at lag 7 and lag 01 (concurrent day and previous 1 day), respectively. The association was more significant in young females (18-29 years) and there was no obvious association observed between SO2 and menstrual disorder outpatient visits. This is the first evidence that short-term exposure to ambient air pollution can be associated with an increased risk of menstrual disorder attacks. The results of our study may help to establish more comprehensive understanding of the health effects of ambient air pollution on menstrual disorders and other reproductive diseases.
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Affiliation(s)
- Zhen Liang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Chen Xu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Troop 94498 of PLA, Nanyang, 474350, China
| | - Yan-Ni Fan
- Medical Record Room of Information Department, Second Affiliated Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, China
| | - Zhi-Qing Liang
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hai-Dong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ren-Jie Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Chun-Yan Yao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hai-Bin Lang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Jie Lei
- Department of Internal Medicine, Hui Long-Ba Town Hospital, Chongqing, 401335, China
| | - Ying-Shu Zhao
- Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine & Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China.
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Impact of PM 2.5 on Second Birth Intentions of China's Floating Population in a Low Fertility Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214293. [PMID: 31694255 PMCID: PMC6862601 DOI: 10.3390/ijerph16214293] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 11/30/2022]
Abstract
The total fertility rate of the Chinese population has declined dramatically over the last three decades. Research has substantiated the causal link between particulate matter (PM) and adverse health effects. However, the impact of PM on the birth intentions or fertility behavior of the childbearing population remains understudied. The paper analyzes the impact of PM2.5 concentration (a mixture of extremely small solid particles and liquid droplets found in the air) on the second birth intentions of the Chinese floating population. We used urban migrant population matching data at the prefectural level for the analysis. The unique datasets were derived from the Chinese Floating Population Dynamic Survey in 2014 administered by the National Health Commission, the National Prefecture-level City Matching Data administered by the National Bureau of Statistics of China, and the air pollution index PM2.5 collected by the Green Peace Organization. The results show that PM2.5 concentration has a negative impact on the second birth intentions of the floating population. This impact exhibits marked regional heterogeneity: the desire for a second birth across migrant groups living in south China decreases if PM2.5 concentration goes up, while migrants coming from, and living in, north China show strong intentions to have a second birth despite an increase in PM2.5 concentration in northern cities. The results have direct implications for the Chinese government at various levels to play a vital role in making and implementing environmental policies on the mitigation of smog to effectively safeguard the health of individuals and communities and potentially raise China’s fertility rate.
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Abstract
Supplemental Digital Content is available in the text. Background: Air pollution has been associated with hypertension and preterm birth. We examined if prenatal exposure to air pollutants was associated with gestational hypertension and if its association with preterm birth was modified by maternal hypertension. Methods: Data were from birth certificates and hospital discharge records of 252,205 women in San Joaquin Valley of California from 2000 to 2006. Air quality data were assigned from 24-hour averages of nitrogen dioxide (NO2), particulate matter <10µm (PM10) and <2.5µm (PM2.5), and carbon monoxide (CO) for different averaging periods over pregnancy. We estimated odds of preterm birth and multiplicative interaction between each pollutant and hypertensive disorder. Results: Among normotensive women, odds of preterm birth were slightly higher for higher exposure to all pollutants over the entire pregnancy. Patterns were similar among women with a hypertensive disorder. Among 32–36 week births, there was effect modification for exposure to NO2 and CO during the first trimester with higher odds among hypertensive women, and PM2.5 and CO during the last 6 weeks with higher odds among normotensive women. For 28–31 week births, there was effect modification by hypertensive status for PM10 exposure for the entire pregnancy, first, and second trimester with hypertensive women consistently having lower odds of preterm birth than normotensive. Conclusion: There was some evidence of effect modification in the direction counter to our hypothesis for exposure to PM10 and early preterm birth, and CO and PM2.5 at the end of pregnancy, but overall, hypertension did not modify the relationship between pollution and preterm birth.
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Ravi N, Vimala Rani P, Rajesh Alias Harinarayan R, Mercy Shalinie S, Seshadri K, Pariventhan P. Deep Learning-based Framework for Smart Sustainable Cities. INTERNATIONAL JOURNAL OF INTELLIGENT INFORMATION TECHNOLOGIES 2019. [DOI: 10.4018/ijiit.2019100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pure air is vital for sustaining human life. Air pollution causes long-term effects on people. There is an urgent need for protecting people from its profound effects. In general, people are unaware of the levels to which they are exposed to air pollutants. Vehicles, burning various kinds of waste, and industrial gases are the top three onset agents of air pollution. Of these three top agents, human beings are exposed frequently to the pollutants due to motor vehicles. To aid in protecting people from vehicular air pollutants, this article proposes a framework that utilizes deep learning models. The framework utilizes a deep belief network to predict the levels of air pollutants along the paths people travel and also a comparison with the predictions made by a feed forward neural network and an extreme learning machine. When evaluating the deep belief neural network for the case study undertaken, a deep belief network was able to achieve a higher index of agreement and lower RMSE values.
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Affiliation(s)
| | | | | | | | - Karthick Seshadri
- National Institute of Technology, Andhra Pradesh, Tadepalligudem, India
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Niederberger C, Pellicer A, Simon C, Kathrins M, Goldstein M, Sigman M, Schlegel PN, Munné S, Gardner DK, Cobo A, Coutifaris C, Donnez J, Taylor HS, Giudice LC, Fauser BC, Lindheim SR, Rosenwaks Z, Casper RF, de Ziegler D, Gibbons WE, Paulson RJ, Laufer N, Klock SC, Mendola P, Sauer MV. 25 historic papers: an ASRM 75th birthday gift from Fertility and Sterility. Fertil Steril 2019; 112:e2-e27. [DOI: 10.1016/j.fertnstert.2019.08.099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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