Air pollution exposure and ovarian reserve impairment in Shandong province, China: The effects of particulate matter size and exposure window

Lihong Pang; Wenhao Yu; Jiale Lv; Yunde Dou; Han Zhao; Shanshan Li; Yuming Guo; Gongbo Chen; Linlin Cui; Jingmei Hu; Yueran Zhao; Qi Zhao; Zi-Jiang Chen

doi:10.1016/j.envres.2022.115056

Air pollution exposure and ovarian reserve impairment in Shandong province, China: The effects of particulate matter size and exposure window

Environ Res. 2023 Feb 1:218:115056. doi: 10.1016/j.envres.2022.115056. Epub 2022 Dec 12.

Authors

Lihong Pang¹, Wenhao Yu², Jiale Lv¹, Yunde Dou¹, Han Zhao¹, Shanshan Li³, Yuming Guo³, Gongbo Chen⁴, Linlin Cui¹, Jingmei Hu¹, Yueran Zhao¹, Qi Zhao⁵, Zi-Jiang Chen⁶

Affiliations

¹ Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China.
² Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
³ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia.
⁴ Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
⁵ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, 40225, Germany. Electronic address: qi.zhao@sdu.edu.cn.
⁶ Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China; Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, Shandong, 250012, China; Shandong Key Laboratory of Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, China; Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, Shandong, 250012, China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China. Electronic address: chenzijiang@hotmail.com.

PMID: 36521537
DOI: 10.1016/j.envres.2022.115056

Abstract

Background: Lack of evidence exists on whether air pollution exposure may affect ovarian reserve, especially for Chinese women.

Objectives: To explore the association between exposure to various air pollutants and anti-Müllerian hormone (AMH), a predictor of ovarian reserve, over different exposure windows in Shandong Province, China.

Methods: We enrolled 18,878 women who had AMH measurements in the Center for Reproductive Medicine, Shandong University during 2010-2019. Daily average concentrations of ambient particulate matter with diameters ≤1 μm/2.5 μm/10 μm (PM₁, PM_2.5, and PM₁₀), nitrogen dioxide (NO₂) and ozone (O₃) were developed at a spatial resolution of 0.01° × 0.01°, and assigned to the residential addresses. Three exposure windows were considered, i.e., the process from primary to small antral follicle stage (W1), from primary to secondary follicle stage (W2), and from secondary to small antral follicle stage (W3). The air pollution-AMH association was fitted using the multivariable linear mixed effect model with adjustment for potential confounders. Stratified analyses were performed by age group, overweight status, residential region, and educational level.

Results: The level of AMH changed by -8.8% (95% confidence interval (CI): -12.1%, -5.3%), -2.1% (95% CI: -3.5%, -0.6%), -1.9% (95% CI: -3.3%, -0.5%), and -4.5% (95% CI: -7.1%, -1.9%) per 10 μg/m³ increase in PM₁, PM_2.5, PM₁₀, and NO₂, respectively, during W1. The effect estimates were significant during W2 for PM₁, PM_2.5 and NO₂ while minimal association was observed in W3. Greater vulnerability for certain air pollutants were observed for women who lived in inland areas and were less educated.

Conclusions: We found that ovarian reserve was negatively associated with air pollution exposure for women, particularly from the primary to secondary follicle stage. The effect estimate increased by the reduction in the diameter of PMs, which also varied across population sub-groups.

Keywords: Ambient air pollutant; Anti-müllerian hormone; Ovarian reserve.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / analysis
China / epidemiology
Environmental Exposure / analysis
Female
Humans
Nitrogen Dioxide / analysis
Ovarian Reserve*
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Particulate Matter
Nitrogen Dioxide
Air Pollutants