14 Living close to major roadways may also affect reproduction: laboratory evidence demonstrates that diesel exhaust, particulate matter, and other combustion-related pollutants have hormonal activity 15–17 and can increase oxidative stress and systemic inflammation. Residential proximity to major roadways may serve as a proxy for a complex set of urban exposures, including traffic-related air pollution, noise, and other spatially-related characteristics, and has been associated with increased risk of cardiovascular 10, 11 and respiratory disease 12, 13 and type 2 diabetes. 9 However, few modifiable risk factors for infertility have been identified. 5–8 As couples delay childbearing, rates of infertility and use of infertility treatments are expected to increase. Treatments for infertility cost up to $5 billion annually in the United States 4 and may be associated with higher risk of adverse pregnancy and child health outcomes. 1–3 Infertility can cause substantial psychological and economic hardship. In addition, we prospectively measured fecundability in women representing the full range of the fertility spectrum, whereas most other studies have relied on retrospective report of time to pregnancy or have been conducted in fertility clinic populations.Īpproximately 10–15% of reproductive-age couples in the United States and Canada experience infertility, defined as the inability to conceive after 12 months of unprotected intercourse. Our analysis overcomes the limitations of previous studies examining this association, including small sample size, limited geographic diversity, and lack of control for neighborhood-level confounding. Among participants residing across the United States and Canada, living close to major roads was associated with reduced fecundability, even after adjustment for individual- and neighborhood-level confounding. This is the largest preconception cohort study to prospectively measure the association between road proximity metrics and fecundability. These results are consistent with the hypothesis that traffic-related air pollution or other near-road exposures may adversely affect fecundability. Likewise, length of major roads within buffers of 50 and 100 meters was associated with lower fecundability in both countries associations were attenuated within larger buffers. The association among Canadian women was similar in magnitude, but less precise (FR = 0.93 95% CI = 0.74, 1.16). In the United States, the FR comparing women who lived <50 meters with those who lived ≥400 meters from the closest major road was 0.88 (95% CI = 0.80, 0.98). We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for individual- and neighborhood-level characteristics. We geocoded residential addresses reported at baseline and during follow-up, and calculated distance to nearest major roads and length of major roads within buffers of 50, 100, 300, and 400 meters around the residence as proxies for traffic-related air pollution. From 2013 to 2019, women 21–45 years old who were trying to conceive without fertility treatment completed an online baseline questionnaire and follow-up questionnaires every 8 weeks for up to 12 months or until pregnancy. Methods:Īmong 7,342 female pregnancy planners from the United States and 1,448 from Canada, we examined the association between residential proximity to major roads and fecundability, the per-cycle probability of conception. The work cannot be changed in any way or used commercially without permission from the journal.Įmerging evidence from animal and human studies indicates that exposure to traffic-related air pollution may adversely affect fertility. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Address: Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, T4E, Boston, MA 02118. Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( *Corresponding Author. Sponsorships or competing interests that may be relevant to content are disclosed at the end of the article. ADepartment of Epidemiology, Boston University School of Public Health, Boston, MassachusettsīDepartment of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WashingtonĬCollege of Public Health and Human Sciences, Oregon State University, Corvalis, OregonĭDepartment of Environmental Health, Boston University School of Public Health, Boston, MassachusettsĮDepartment of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkįResearch Triangle Institute, Durham, North Carolina
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