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

Bjorvang, Richelle D. (författare)
Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Obstet & Gynecol, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Unit Toxicol Sci, Swetox, Sodertalje, Sweden.
Gennings, Chris (författare)
Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA.,Icahn School of Medicine at Mount Sinai
Lin, Ping-I (författare)
Karlstads universitet,Institutionen för hälsovetenskaper (from 2013)
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Hussein, Ghada (författare)
Karlstad Cent Hosp, Dept Obstet & Gynecol, Karlstad, Sweden.,Karlstad Hospital
Kiviranta, Hannu (författare)
Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.,Finnish National Institute for Health and Welfare
Rantakokko, Panu (författare)
Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.,Finnish National Institute for Health and Welfare
Ruokojarvi, Paivi (författare)
Natl Inst Hlth & Welf, Dept Hlth Secur, Kuopio, Finland.
Lindh, Christian H. (författare)
Lund University,Lunds universitet,Tillämpad masspektrometri inom miljömedicin,Forskargrupper vid Lunds universitet,Applied Mass Spectrometry in Environmental Medicine,Lund University Research Groups
Damdimopoulou, Pauliina (författare)
Karolinska Institutet,Karolinska University Hospital
Bornehag, Carl-Gustaf, 1957- (författare)
Karlstads universitet,Institutionen för hälsovetenskaper (from 2013),Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
Björvang, Richelle D. (författare)
Karolinska Institutet,Karolinska University Hospital
Lin, Ping I. (författare)
Karlstad University
Ruokojärvi, Päivi (författare)
Finnish National Institute for Health and Welfare
Bornehag, Carl Gustaf (författare)
Karlstad University,Icahn School of Medicine at Mount Sinai
Hussein, G (författare)
Kiviranta, H (författare)
Ruokojarvi, P (författare)
Rantakokko, P (författare)
Lindh, CH (författare)
Bjorvang, RD (författare)
Karolinska Institutet
Gennings, C (författare)
Lin, PI (författare)
Bornehag, CG (författare)
Damdimopoulou, P (författare)
Karolinska Institutet
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Karolinska Inst, Dept Clin Sci Intervent & Technol, Div Obstet & Gynecol, Stockholm, Sweden;Karolinska Univ Hosp, Stockholm, Sweden.;Karolinska Inst, Unit Toxicol Sci, Swetox, Sodertalje, Sweden. Icahn Sch Med Mt Sinai, Dept Environm Med & Publ Hlth, New York, NY 10029 USA. (creator_code:org_t)
BMC, 2020
Ingår i: Environmental health. - : BMC. - 1476-069X .- 1476-069X. ; 19:1
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • Background We 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. Methods Using 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. Results Prior 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. Conclusion Serum 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.


MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskaper -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Environmental Health and Occupational Health (hsv//eng)


Persistent organic pollutants
Combined oral contraceptives
Organochlorinated pesticides
Brominated diphenyl ethers
Public Health Science
Brominated diphenyl ethers

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