Persistent organic pollutants, pre-pregnancy use of combined oral contraceptives, age, and time-to-pregnancy in the SELMA cohort View Full Text


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Article Info

DATE

2020-06-15

AUTHORS

Richelle D. Björvang, Chris Gennings, Ping-I Lin, Ghada Hussein, Hannu Kiviranta, Panu Rantakokko, Päivi Ruokojärvi, Christian H. Lindh, Pauliina Damdimopoulou, Carl-Gustaf Bornehag

ABSTRACT

BackgroundWe are exposed to several chemicals such as persistent organic pollutants (POPs) in our everyday lives. Prior evidence has suggested that POPs may have adverse effects on reproductive function by disrupting hormone synthesis and metabolism. While there is age-related decline of fertility, the use of hormonal combined oral contraceptives (COCs) and its association to return of fertility remains controversial. The goal of this study is to investigate the association between exposure to POPs, both individually and as a mixture, and fecundability measured as time-to-pregnancy (TTP) according to pre-pregnancy use of COCs and age.MethodsUsing the SELMA (Swedish Environmental Longitudinal Mother and Child, Allergy and Asthma) study, we have identified 818 pregnant women aged 18–43 years (mean 29 years) with data on how long they tried to get pregnant and what was their most recently used contraceptive method. These data were collected at enrollment to the study (median week 10 of pregnancy). Concentrations of 22 POPs and cotinine were analyzed in the blood samples collected at the same time as the questions on TTP and pre-pregnancy use of contraceptive. Analyses were done on the association between POPs exposure and TTP measured as continuous (months) and binary (infertile for those with TTP > 12 months). To study the chemicals individually, Cox regression and logistic regression were used to estimate fecundability ratios (FRs) and odds ratios (ORs), respectively. Weighted quantile sum (WQS) regression was used to investigate the chemicals as a mixture where chemicals of concern were identified above the 7.6% threshold of equal weights. To perform the subgroup analysis, we stratified the sample according to use of COCs as the most recent pre-pregnancy contraception method and age (< 29 years, and ≥ 29 years). The models were adjusted for parity, regularity of menses, maternal body mass index (BMI) and smoking status, and stratified as described above.ResultsPrior to stratification, none of the POPs were associated with fecundability while increased exposure to HCB, PCB 74 and 118 had higher odds of infertility. Upon stratification, POP exposure was significantly associated with longer TTP in women aged ≥29 years who did not use COC. Specifically, PCBs 156, 180, 183, and 187 were associated with reduced fecundability while PCBs 99, 153, 156, 180, 183, and 187 had higher odds of infertility. As a mixture, we identified the chemicals of concern for a longer TTP include PCBs 118, 156, 183, and 187. Moreover, chemicals of concern identified with increased odds of infertility were PCB 74, 156, 183, 187, and transnonachlor.ConclusionSerum concentrations of selected POPs, both as individual chemicals and as a mixture, were significantly associated with lower fecundability and increased odds of infertility in women aged 29 years and above not using COC as their most recent pre-pregnancy contraceptive. Our findings suggest that pre-pregnancy use of oral contraceptive and age may modify the link between POPs and fecundability. The differences of specific chemicals in the individual analysis and as a mixture support the need to study combination effects of chemicals when evaluating reproductive outcomes. More... »

PAGES

67

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12940-020-00608-8

DOI

http://dx.doi.org/10.1186/s12940-020-00608-8

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https://app.dimensions.ai/details/publication/pub.1128490471

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32539770


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24 schema:description BackgroundWe are exposed to several chemicals such as persistent organic pollutants (POPs) in our everyday lives. Prior evidence has suggested that POPs may have adverse effects on reproductive function by disrupting hormone synthesis and metabolism. While there is age-related decline of fertility, the use of hormonal combined oral contraceptives (COCs) and its association to return of fertility remains controversial. The goal of this study is to investigate the association between exposure to POPs, both individually and as a mixture, and fecundability measured as time-to-pregnancy (TTP) according to pre-pregnancy use of COCs and age.MethodsUsing the SELMA (Swedish Environmental Longitudinal Mother and Child, Allergy and Asthma) study, we have identified 818 pregnant women aged 18–43 years (mean 29 years) with data on how long they tried to get pregnant and what was their most recently used contraceptive method. These data were collected at enrollment to the study (median week 10 of pregnancy). Concentrations of 22 POPs and cotinine were analyzed in the blood samples collected at the same time as the questions on TTP and pre-pregnancy use of contraceptive. Analyses were done on the association between POPs exposure and TTP measured as continuous (months) and binary (infertile for those with TTP > 12 months). To study the chemicals individually, Cox regression and logistic regression were used to estimate fecundability ratios (FRs) and odds ratios (ORs), respectively. Weighted quantile sum (WQS) regression was used to investigate the chemicals as a mixture where chemicals of concern were identified above the 7.6% threshold of equal weights. To perform the subgroup analysis, we stratified the sample according to use of COCs as the most recent pre-pregnancy contraception method and age (< 29 years, and ≥ 29 years). The models were adjusted for parity, regularity of menses, maternal body mass index (BMI) and smoking status, and stratified as described above.ResultsPrior to stratification, none of the POPs were associated with fecundability while increased exposure to HCB, PCB 74 and 118 had higher odds of infertility. Upon stratification, POP exposure was significantly associated with longer TTP in women aged ≥29 years who did not use COC. Specifically, PCBs 156, 180, 183, and 187 were associated with reduced fecundability while PCBs 99, 153, 156, 180, 183, and 187 had higher odds of infertility. As a mixture, we identified the chemicals of concern for a longer TTP include PCBs 118, 156, 183, and 187. Moreover, chemicals of concern identified with increased odds of infertility were PCB 74, 156, 183, 187, and transnonachlor.ConclusionSerum concentrations of selected POPs, both as individual chemicals and as a mixture, were significantly associated with lower fecundability and increased odds of infertility in women aged 29 years and above not using COC as their most recent pre-pregnancy contraceptive. Our findings suggest that pre-pregnancy use of oral contraceptive and age may modify the link between POPs and fecundability. The differences of specific chemicals in the individual analysis and as a mixture support the need to study combination effects of chemicals when evaluating reproductive outcomes.
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31 schema:keywords BackgroundWe
32 ConclusionSerum concentrations
33 Cox regression
34 HCB
35 PCB 118
36 PCB 156
37 PCB 74
38 PCB 99
39 POP exposure
40 SELMA study
41 TTP
42 adverse effects
43 age
44 age-related decline
45 analysis
46 association
47 binaries
48 blood samples
49 body mass index
50 chemicals
51 chemicals of concern
52 cohort
53 combination effect
54 combined oral contraceptives
55 concentration
56 concern
57 contraception methods
58 contraceptive methods
59 contraceptives
60 cotinine
61 data
62 decline
63 differences
64 effect
65 enrollment
66 equal weight
67 everyday life
68 evidence
69 exposure
70 fecundability
71 fecundability ratios
72 fertility
73 findings
74 function
75 goal
76 higher odds
77 hormone synthesis
78 index
79 individual analysis
80 individual chemicals
81 infertility
82 life
83 link
84 logistic regression
85 longer TTP
86 lower fecundability
87 mass index
88 maternal body mass index
89 menses
90 metabolism
91 method
92 mixture
93 model
94 need
95 odds
96 odds of infertility
97 oral contraceptives
98 organic pollutants
99 outcomes
100 parity
101 persistent organic pollutants
102 pollutants
103 pre-pregnancy use
104 pregnancy
105 pregnant women
106 prior evidence
107 quantile sum (WQS) regression
108 questions
109 ratio
110 reduced fecundability
111 regression
112 regularity
113 regularity of menses
114 reproductive function
115 reproductive outcomes
116 same time
117 samples
118 smoking status
119 specific chemicals
120 status
121 stratification
122 study
123 subgroup analysis
124 synthesis
125 threshold
126 time
127 transnonachlor
128 use
129 use of contraceptives
130 weight
131 women
132 years
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