Perfluoroalkyl Chemicals, Menstrual Cycle Length, and Fecundity Findings from a Prospective Pregnancy Study

• Type of Material: Article
• Authors: Kirsten J. Lum, Eunice Kennedy Shriver Natl Inst Child Hlth & Hum; Rajeshwari Sundaram, Eunice Kennedy Shriver Natl Inst Child Hlth & Hum; Dana Boyd Barr, Emory University; Thomas A. Louis, Johns Hopkins University; Germaine M. Buck Louis, Eunice Kennedy Shriver Natl Inst Child Hlth & Hum
• Language: English
• Date: 2017-01-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Wolters Kluwer Health, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1097/EDE.0000000000000552
• Title of Journal or Parent Work: Epidemiology
• ISSN: 1044-3983
• Volume: 28
• Issue: 1
• Start Page: 90
• End Page: 98
• Grant/Funding Information: This research was funded by the NIH, Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [contracts N01-HD-3-3355, N01-HD-3-3356, N01-HD-3-3358].; K.J.L. was supported by an Intramural Research Training Award from the NICHD and a training grant from the National Institute of Environmental Health Sciences [Training Grant 2T32ES012871].
• Keywords: Science & Technology; Public, Environmental & Occupational Health; PROSPECTIVE COHORT; SUBSTANCES; EXPOSURE; FERTILITY; CONTAMINANTS; Life Sciences & Biomedicine; ASSOCIATION; SERUM COTININE; PERFLUORINATED CHEMICALS; TIME; SUBFECUNDITY
• Research Categories: Health Sciences, Public Health; Environmental Sciences

Abstract

Background: Perfluoroalkyl substances have been associated with changes in menstrual cycle characteristics and fecundity, when modeled separately. However, these outcomes are biologically related, and we evaluate their joint association with exposure to perfluoroalkyl substances. Methods: We recruited 501 couples from Michigan and Texas in 2005-2009 upon their discontinuing contraception and followed them until pregnancy or 12 months of trying. Female partners provided a serum sample on enrollment and completed daily journals on menstruation, intercourse, and pregnancy test results. We measured seven perfluoroalkyl substances in serum using liquid chromatography-tandem mass spectrometry. We assessed the association between perfluoroalkyl substances and menstrual cycle length using accelerated failure time models and between perfluoroalkyl substances and fecundity using a Bayesian joint modeling approach to incorporate cycle length. Results: Menstrual cycles were 3% longer comparing women in the second versus first tertile of perfluorodecanoate (PFDeA; acceleration factor [AF] = 1.03, 95% credible interval [CrI] = [1.00, 1.05]), but 2% shorter for women in the highest versus lowest tertile of perfluorooctanoic acid (PFOA; AF = 0.98, 95% CrI = [0.96, 1.00] ). When accounting for cycle length, relevant covariates, and remaining perfluoroalkyl substances, the probability of pregnancy was lower for women in second versus first tertile of perfluorononanoate (PFNA; odds ratio [OR] = 0.6, 95% CrI = [0.4, 1.0] ) although not when comparing the highest versus lowest (OR = 0.7, 95% CrI = [0.3, 1.1]) tertile. Conclusions: In this prospective cohort study, we observed associations between two perfluoroalkyl substances and menstrual cycle length changes, and between select perfluoroalkyl substances and diminished fecundity at some (but not all) concentrations. See video abstract at, http://links.lww.com/EDE/B136.