PMID- 32539770 OWN - NLM STAT- MEDLINE DCOM- 20201124 LR - 20231111 IS - 1476-069X (Electronic) IS - 1476-069X (Linking) VI - 19 IP - 1 DP - 2020 Jun 15 TI - Persistent organic pollutants, pre-pregnancy use of combined oral contraceptives, age, and time-to-pregnancy in the SELMA cohort. PG - 67 LID - 10.1186/s12940-020-00608-8 [doi] LID - 67 AB - 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. FAU - Bjorvang, Richelle D AU - Bjorvang RD AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. AD - Unit of Toxicology Sciences, Swetox, Karolinska Institute, Sodertalje, Sweden. FAU - Gennings, Chris AU - Gennings C AD - Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA. FAU - Lin, Ping-I AU - Lin PI AD - Department of Health Sciences, Karlstad University, Karlstad, Sweden. FAU - Hussein, Ghada AU - Hussein G AD - Department of Obstetrics and Gynecology, Karlstad Central Hospital, Karlstad, Sweden. FAU - Kiviranta, Hannu AU - Kiviranta H AD - Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland. FAU - Rantakokko, Panu AU - Rantakokko P AD - Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland. FAU - Ruokojarvi, Paivi AU - Ruokojarvi P AD - Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland. FAU - Lindh, Christian H AU - Lindh CH AD - Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund, Sweden. FAU - Damdimopoulou, Pauliina AU - Damdimopoulou P AD - Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. AD - Unit of Toxicology Sciences, Swetox, Karolinska Institute, Sodertalje, Sweden. FAU - Bornehag, Carl-Gustaf AU - Bornehag CG AUID- ORCID: 0000-0003-0417-1686 AD - Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA. carl-gustaf.bornehag@kau.se. AD - Department of Health Sciences, Karlstad University, Karlstad, Sweden. carl-gustaf.bornehag@kau.se. LA - eng GR - Keeping eggs healthy/Jane ja Aatos Erkon Saatio/International GR - EDC2020/Svenska Forskningsradet Formas/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200615 PL - England TA - Environ Health JT - Environmental health : a global access science source JID - 101147645 RN - 0 (Contraceptives, Oral, Combined) RN - 0 (Environmental Pollutants) SB - IM MH - Adult MH - Age Factors MH - Cohort Studies MH - Contraceptives, Oral, Combined/*administration & dosage MH - Environmental Pollutants/*analysis MH - Female MH - Humans MH - *Maternal Exposure MH - Sweden MH - *Time-to-Pregnancy MH - Young Adult PMC - PMC7294652 OTO - NOTNLM OT - Brominated diphenyl ethers OT - Combined oral contraceptives OT - Fecundability OT - Organochlorinated pesticides OT - Persistent organic pollutants OT - Polychlorobiphenyls OT - Time-to-pregnancy COIS- The authors declare that they have no competing interests. EDAT- 2020/06/17 06:00 MHDA- 2020/11/25 06:00 PMCR- 2020/06/15 CRDT- 2020/06/17 06:00 PHST- 2019/10/09 00:00 [received] PHST- 2020/05/11 00:00 [accepted] PHST- 2020/06/17 06:00 [entrez] PHST- 2020/06/17 06:00 [pubmed] PHST- 2020/11/25 06:00 [medline] PHST- 2020/06/15 00:00 [pmc-release] AID - 10.1186/s12940-020-00608-8 [pii] AID - 608 [pii] AID - 10.1186/s12940-020-00608-8 [doi] PST - epublish SO - Environ Health. 2020 Jun 15;19(1):67. doi: 10.1186/s12940-020-00608-8.