NDLI: Serum dioxin concentrations and time to pregnancy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Eskenazi, Brenda Warner, Marcella Marks, Amy R. Samuels, Steven Needham, Larry Brambilla, Paolo Mocarelli, Paolo
Spatial Coverage	Italy
Description	Country affiliation: United States Author Affiliation: Eskenazi B ( School of Public Health, University of California at Berkeley, Berkeley, CA 94720-7380, USA. eskenazi@berkeley.edu)
Abstract	BACKGROUND: Pollution may play a role in population trends of declining semen quality and regional differences in time to pregnancy (TTP) in industrialized societies. Dioxins including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) have been suspected. In 1976, an explosion near Seveso, Italy resulted in the highest TCDD exposure known in residential populations. Twenty years later, we conducted a retrospective cohort study, the Seveso Women's Health Study. METHODS: Of 981 participants, 472 women attempted pregnancy after the explosion, and 278 delivered a livebirth not associated with contraceptive failure. Individual serum TCDD levels were measured from samples collected soon after the explosion and extrapolated to the conception attempt. We examined the relation of TCDD levels to time to pregnancy (parameterized as the monthly probability of conception within the first 12 months of trying) and to infertility (defined as conception after at least 12 months of trying). We modeled fecundability with discrete-time Cox proportional hazards regression, and we modeled fertility with logistic regression. We tested the sensitivity of the conclusions to differing definitions of eligibility and outcome. RESULTS: Median TCDD level was 50 parts per trillion, median time to pregnancy was 2 months, and 17% reported taking 12 or more months to conceive. For every 10-fold increase in serum TCDD, we observed a 25% increase in time to pregnancy (adjusted-fecundability odds ratio = 0.75 [95% confidence interval (CI) = 0.60-0.95]) and about a doubling in odds of infertility (adjusted odds ratio = 1.9 [95% CI = 1.1-3.2]). Results were similar for extrapolated TCDD and sensitivity analyses. CONCLUSIONS: We found dose-related increases in TTP and infertility associated with individual serum TCDD levels in the women from Seveso, Italy. These findings may have implications for fertility in industrialized areas.
File Format	HTM / HTML
ISSN	10443983
Issue Number	2
Volume Number	21
e-ISSN	15315487
Journal	Epidemiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Public Health Discipline Epidemiology Fertilization Drug Effects Blood Adolescent Adult Child Child, Preschool Cohort Studies Confidence Intervals Female Physiology Humans Infant Infant, Newborn Infertility, Female Chemically Induced Epidemiology Italy Logistic Models Odds Ratio Adverse Effects Pregnancy Proportional Hazards Models Seveso Accidental Release Statistics & Numerical Data Time Factors Young Adult Journal Article Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Research Support, U.s. Gov't, Non-p.h.s.
Content Type	Text
Resource Type	Article
Subject	Epidemiology

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