Environmental Effects On Fertility

环境对生育力的影响

• 批准号: 8553705
• 负责人: DONNA D. BAIRD
• 金额: $ 15.02万
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8553705
• 关键词: Accounting; Affect; African American; Age; Agriculture; Anti-Inflammatory Agents; Anti-inflammatory; Area; Book Chapters; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Conceptus; Data; Development; Enrollment; Epidemiologic Studies; Female; Fertility; Fertility Study; Follow-Up Studies; Goals; Health; Hemorrhage; Hormones; Human; Human Chorionic Gonadotropin; Intervention; Interview; Investigation; Length; Measurement; Medical; Menarche; Menstrual cycle; Methods; Monitor; Outcome; Outcome Measure; Pain; Participant; Patient Self-Report; Pharmaceutical Preparations; Pilot Projects; Pregnancy; Pregnancy Outcome; Pregnancy Tests; Pregnancy loss; Protocols documentation; Published Comment; Publishing; Questionnaires; Reporting; Reproduction; Reproductive Process; Research; Resources; Review Literature; Risk; Risk Factors; Sampling; Self-Administered; Sister; Specimen; Spontaneous abortion; Steroids; Time; Urine; Validity of Self Report; Woman; Women' s Health; Work; age related; birth control; design; early life exposure; interest; mullerian-inhibiting hormone; pesticide exposure; phthalates; primary outcome; prospective; reproductive hormone; stability testing

Data from the Early Pregnancy Study (EPS) (A.Wilcox, PI) provide a resource for ongoing research into reproductive hormones, fertility, & early pregnancy. During field work for this study in 1982-1985, women enrolled at the time they stopped using birth control in order to conceive. We followed them through their 8th week of pregnancy. They collected daily first morning urine specimens and these were analyzed for human chorionic gonadotropin and steroid metabolites. Women with known fertility problems were excluded, so the sample represents normal unassisted reproduction. We conducted a pilot study to test the stability of hormones in urines stored from the Early Pregnancy Study. Pilot work supported the validity of BPA and phthalate measurements in the EPS urines after long-term storage, so we have designed a study to look at the association of those exposures with fertility and pregnancy outcomes in EPS. We designed a sample selection protocol (pool of 3 separate daily specimens) to the assess levels in each participant menstrual cycle and each clinical pregnancy. These have been analyzed at CDC. In preliminary analysis of the BPA data, there is no evidence of an association between BPA and early pregnancy loss. We will next look at time to pregnancy. Epidemiologic study of menstrual characteristics, fertility, and miscarriage relies on self-report because these outcomes are not systematically monitored by medical care protocols. Therefore, study validity depends upon the accuracy of self-report for these outcomes. We have evaluated the validity of self-reported cycle characteristics by comparing interview data to prospective daily recording of menstrual bleeding and pain. In another methodologic project, we are using available data to determine how well women can report the timing of their positive pregnancy test. Bias arises in spontaneous abortion & time-to-pregnancy studies when comparing exposed and unexposed groups that differ in timing of pregnancy testing. Those who tend to have delayed pregnancy testing will recognize fewer spontaneous abortions, and they will have longer times to pregnancy. In another analysis we are comparing self-reported retrospective data on time to pregnancy with prospectively-collected data (documented for participants in the Early Pregnancy Study during their participation). Participants were traced and sent a self-administered questionnaire to collect their retrospective self-reports. These data are currently being analyzed. We are also studying length of human gestation using EPS data. In the EPS followup we collected detailed delivery data for the EPS pregnancy, so that we could identify which pregnancies ended with spontaneous labor and which ended as a result of medical intervention (induction of labor on C-section before labor). Such medical intervention artificially shortens gestation and must be taken into account when studying human gestation. I have done a comprehensive literature review of female fecundability studies (to be published as a book chapter in a new edition of Women & Health). We continue our research into factors affecting fertility. We are looking at pesticide exposure using data from the Agricultural Health Study. In addition, we have a special interest in female age-related decline in fertility. An ongoing prospective time-to-pregnancy study is providing data on antimullerian hormone as a potential marker of fecundability. The potential for this hormone to be used as an ancillary or primary outcome measure for studies of female fecundability needs further investigation, and the need for this new area of investigation has been presented in a commentary. We have examined the effects of early life exposures on age of menarche using data from the Sister Study. In work as a collaborator on Kathie Hartmanns Right From The Start study, we have found that early pregnancy miscarriage rates are very similar for African American and white women, but African Americans have nearly twice the risk of miscarriage during gestational weeks 10-20 compared to white women. Data from this study also demonstrated no evidence of early pregnancy non-steroidal anti-inflammatory medication being a risk factor for miscarriage.

来自早孕研究(EPS)(A.Wilcox，PI)的数据为正在进行的生殖激素、生育和早孕研究提供了资源。在1982-1985年这项研究的实地工作期间，妇女在停止使用节育措施以怀孕的时候登记。我们跟踪他们，直到他们怀孕8周。他们收集了每天第一个早晨的尿样，并对这些样本进行了人类绒毛膜促性腺激素和类固醇代谢物的分析。已知有生育问题的女性被排除在外，因此样本代表了正常的无辅助生殖。我们进行了一项初步研究，以测试从怀孕早期研究中储存的尿液中激素的稳定性。 试点工作支持长期储存后EPS尿液中BPA和邻苯二甲酸盐测量的有效性，因此我们设计了一项研究，以观察EPS中这些暴露与生育和妊娠结局的关系。我们设计了一个样本选择方案(每天3个单独的样本池)来评估每个参与者月经周期和每个临床妊娠的水平。美国疾病控制与预防中心对这些数据进行了分析。在对双酚A数据的初步分析中，没有证据表明双酚A与早孕丢失有关。接下来我们来看看怀孕的时间。 月经特征、生育和流产的流行病学研究依赖于自我报告，因为这些结果不受医疗方案的系统监测。因此，研究的有效性取决于对这些结果的自我报告的准确性。通过将访谈数据与预期的月经出血和疼痛每日记录进行比较，我们评估了自我报告的周期特征的有效性。在另一个方法论项目中，我们正在使用现有的数据来确定女性报告怀孕测试阳性的时间有多好。在自然流产-怀孕时间研究中，当比较暴露组和非暴露组在妊娠检测时间上的不同时，就会产生偏差。那些倾向于推迟怀孕测试的人会意识到自然流产较少，而且他们怀孕的时间会更长。在另一项分析中，我们将自我报告的怀孕时间回顾数据与预期收集的数据(为参与早期怀孕研究的参与者在参与期间记录的数据)进行比较。参与者被跟踪并发送了一份自我管理的问卷，以收集他们的回溯性自我报告。这些数据目前正在分析中。 我们还在使用EPS数据研究人类妊娠的长度。在EPS随访中，我们收集了EPS妊娠的详细分娩数据，以便我们能够确定哪些妊娠是以自然分娩结束的，哪些是由于药物干预(产前剖宫产引产)而终止的。这种医学干预人为地缩短了妊娠，在研究人类妊娠时必须考虑到这一点。 我对女性受孕能力的研究做了全面的文献回顾(将作为新版《妇女与健康》的一章出版)。我们继续研究影响生育率的因素。我们正在使用农业健康研究的数据来研究农药暴露。此外，我们对女性与年龄相关的生育率下降特别感兴趣。一项正在进行的前瞻性怀孕时间研究正在提供关于抗髓鞘激素作为受精性的潜在标志的数据。这种激素作为女性受精性研究的辅助或主要结果指标的可能性需要进一步调查，这一新的调查领域的必要性已在一篇评论中提出。 我们使用Sister研究的数据研究了早期生活暴露对月经初潮年龄的影响。 作为Kathie Hartmanns的合作者，我们从Start研究开始就发现，非洲裔美国人和白人女性的早孕流产率非常相似，但与白人女性相比，非洲裔美国人在怀孕10-20周期间流产的风险几乎是白人女性的两倍。这项研究的数据也没有证据表明怀孕早期非类固醇抗炎药物是流产的危险因素。