Air pollution exposure and pregnancy outcomes among women with polycystic ovary syndrome

Abstract

BackgroundRecently, the relationship between air pollution and reproductive outcomes has become a research focus. However, there is a lack of research on the relationship between air pollution and polycystic ovary syndrome (PCOS).MethodsThis is a retrospective cohort study included a total of 1,652 women with PCOS and 12,543 women without PCOS conducted from 1 January 2015 to 31 December 2019. The average daily concentration data of six air pollutants (PM2.5, PM10, O3, NO2, SO2, and CO) during different exposure windows were obtained. Generalized estimating equation models were used to evaluate the association of air pollution with pregnancy outcomes.ResultsAir pollutants were not found to have a significant association with pregnancy rates among patients with PCOS. However, each IQR increase in PM10 exposure during period 3 (embryo transfer to serum HCG test) was associated with the reduced clinical pregnancy rate (adjusted OR = 0.92, 95% CI: 0.84–0.99) for patients without PCOS. Patients without PCOS showed lower clinical pregnancy rates with increased exposure to NO2 during periods 2 (oocyte retrieval to embryo transfer) and 5 (start of gonadotropin medication to embryo transfer), with aORs and 95% CIs of 0.94 (0.88, 0.99) and 0.94 (0.88, 0.98), respectively. Each IQR increase in SO2 among patients without PCOS during periods 1 (start of gonadotropin medication to oocyte retrieval), 2, 5, and 6 (start of gonadotropin medication to serum HCG test) was related to a decrease in clinical pregnancy rate. For the live birth rate, no significant relationship was found between air pollutants, including PM2.5, PM10, SO2, NO2, CO, and O3, and the live birth rate for women with PCOS. However, women without PCOS presented a lower probability of live birth with exposure to SO2 during periods 1, 2, 5, and 6.ConclusionThis retrospective study of reproductive-aged women observed no significant relationships between ambient pollutants and pregnancy outcomes among women with PCOS but found negative associations among women without PCOS.

A Systematic Review of Microparticulate Air Pollution in Polycystic Ovary Syndrome

“…Air pollution is an increasing global problem that has been associated with a wide variety of human diseases, including PCOS (5,(29)(30)(31)(48)(49)(50). Air polution consists of a range of components including gases (SO2, NOx, NO, NO2) and suspended particulates of different sizes.…”

“…Microparticulate air pollution is believed to account for a large proportion of the public health impact of air pollution, including reproductive diseases (50,52). MAP has been associated with menstrual irregularity (53), infertility (25,30), adverse pregnancy outcomes (31), increased incidence of PCOS (5,29), and has also been linked to transgenerational transmission and infant weight gain (54,55). Human studies have shown that metabolites of tobacco (cadmium, cotine) can be found in ovarian follicular fluid and may potentially affect the developing egg (42,53).…”

“…3.2.4. Air pollution exposure and pregnancy outcomes (31) Zhu et al (31) performed a retrospective cohort study of 1,652 women with PCOS compared to a control group of 12,543 women with tubal factor or male factor infertility receiving in-vitro fertilization treatment. The investigators evaluated the average daily concentrations of exposure to PM2.5, PM10, SO2, NO2, CO, and O3, during 6 different exposure periods of the IVF cycle.…”

“…Previous studies have shown that ambient particulate matter can adversely affect sperm quality (43) and other pregnancy outcomes in the general population (31,44). Epidemiological data have linked air pollution exposure to miscarriage, preterm birth (45,46), low birthweight (45), and preeclampsia (47).…”