Compliance with daily, home-based collection of urinary biospecimens in a prospective, preconception cohort.
Compliance with daily, home-based collection of urinary biospecimens in a prospective, preconception cohort.
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DOI：
10.1097/ee9.0000000000000050
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发表时间：
2019-06-01
期刊：
影响因子：
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通讯作者：
Porucznik, Christina A
中科院分区：
文献类型：
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作者：
Cox, Kyley J;Stanford, Joseph B;Porucznik, Christina A
背景：围孕期环境中的暴露可能会影响生育能力和未来的健康。评估围孕窗口期间随时间变化的暴露需要确定排卵周围的近似受孕窗口。在这项前瞻性队列研究中，我们指导女性进行日常宫颈液观察和解读，以确定早期排卵；他们利用这些信息来确定双方每日尿液收集的时间。将收集的时间和完整性与专家评审进行比较。方法：从2011年至2015年从社区志愿者中招募170对计划怀孕的夫妇；女性接受了高峰日方法来识别受孕窗口期。双方从生育质量液体（生育窗口开始的估计值）的第一天开始每天收集尿液样本。男性在预计排卵日/受孕日+2天停药；女性持续到下一次月经开始，或在预计排卵日/受孕日+18天时妊娠试验呈阳性。我们将样本的日期与参与者的生育力图表进行比较，以确定正确收集的比例。此外，专家评审员还判断了应该收集尿液的日期，确定了研究者确定的采样日期。 结果：169 对夫妇提交了 284 个周期的 6,118 份尿液样本。审查者和参与者在 87% 的周期中就受孕窗口开始日期 ±3 天达成一致（65% 的确切日期一致）；排卵日期 ±3 天的一致性为 93%（确切日期一致性为 75%）。根据研究者确定的采样日，预计女性样本 5,329 份，共采集 4,546 份，其中 82% 在预计日正确采集。相对于研究者确定的采样日，正确采集了 59% 的男性样本。结论：密集安排的、生物触发的家庭生物样本采集可以成功地针对围孕期窗口，并在纵向队列研究中完成。
BACKGROUND: Exposures in the periconceptional environment may impact fertility and future health. Assessing time-varying exposures during the periconceptional window requires identifying approximate fertile windows around ovulation. In this prospective cohort study, we instructed women in daily cervical fluid observation and interpretation to identify incipient ovulation; they used this information to time daily urine collection for both partners. Timing and completeness of collection were compared to expert review.METHODS: One hundred seventy couples planning pregnancy enrolled from community volunteers from 2011 to 2015; women were taught the Peak Day method to identify fertile windows. Both partners collected daily urine specimens from the first day of fertile-quality fluid (estimator of the beginning of fertile window). Men discontinued on the estimated day of ovulation/conception +2 days; women continued through the onset of next menses, or positive pregnancy test at estimated day of ovulation/conception +18 days. We compared dates from samples with participants' fertility charts to determine proportion correctly collected. Also, expert reviewers judged on which days urine should have been collected, determining investigator-identified sampling days.RESULTS: One hundred sixty-nine couples submitted 6,118 urine samples from 284 cycles. Reviewers and participants agreed in 87% of cycles for the date of the beginning of the fertile window ±3 days (65% exact-day agreement); agreement on ovulation date, ±3 days, was 93% (75% exact-day agreement). Five thousand three hundred twenty-nine female samples were expected based on investigator-identified sampling days, and 4,546 were collected, of which 82% were correctly collected on expected days. Fifty-nine percent of male samples were correctly collected relative to investigator-identified sampling days.CONCLUSIONS: Intensively-scheduled, biologically-triggered, at-home biospecimen collection can successfully be targeted to the periconceptional window and completed in a longitudinal cohort study.