Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 188, Issue 9, Pages 1595-1604Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwz151
Keywords
air pollution; fecundity; fertility; folate; infertility; pregnancy loss; traffic
Categories
Funding
- National Institute of Environmental Health Sciences [ES009718, ES022955, ES000002, K99ES026648]
- National Institute of Diabetes and Digestive and Kidney Diseases [P30DK046200]
- US Environmental Protection Agency [RD834798, RD-83587201]
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Traffic-related air pollution has been linked to higher risks of infertility and miscarriage. We evaluated whether folate intake modified the relationship between air pollution and livebirth among women using assisted reproductive technology (ART). Our study included 304 women (513 cycles) presenting to a fertility center in Boston, Massachusetts (2005-2015). Diet and supplements were assessed by food frequency questionnaire. Spatiotemporal models estimated residence-based daily nitrogen dioxide (NO2), ozone, fine particulate, and black carbon concentrations in the 3 months before ART. We used generalized linear mixed models with interaction terms to evaluate whether the associations between air pollutants and livebirth were modified by folate intake, adjusting for age, body mass index, race, smoking, education, infertility diagnosis, and ART cycle year. Supplemental folate intake significantly modified the association of NO2 exposure and livebirth (P = 0.01). Among women with supplemental folate intakes of <800 mu g/day, the odds of livebirth were 24% (95% confidence interval: 2, 42) lower for every 20-parts-per-billion increase in NO2 exposure. There was no association among women with intakes of >= 800 mu g/day. There was no effect modification of folate on the associations between other air pollutants and livebirth. High supplemental folate intake might protect against the adverse reproductive consequences of traffic-related air pollution.
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