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PROSPECTIVE PREGNANCY STUDY DESIGNS FOR ASSESSING REPRODUCTIVE AND DEVELOPMENTAL TOXICANTS
Citation:
Buck, G. M., C. D. Johnson, J C. Rockett, L. Schieve, S. Schrader, S G. Selevan, J. Stanford, AND A. Sweeney. PROSPECTIVE PREGNANCY STUDY DESIGNS FOR ASSESSING REPRODUCTIVE AND DEVELOPMENTAL TOXICANTS. Presented at American Epidemiology Society Meeting, Atlanta, GA, March 27-28, 2003.
Description:
Of late, there is increasing recognition that exposures before, at or shortly after conception have life-long implications for human reproduction and development. Despite this evolving literature, few research initiatives have been designed to empirically evaluate exposures during these sensitive windows of human development. Prospective pregnancy cohort studies can be designed to fill critical data gaps regarding reproductive and developmental toxicants (RADT). However, the design is often described as being difficult to conduct, costly and yielding biased results. To empirically evaluate the utility and feasibility of this design, we systematically identified published prospective pregnancy studies using the following keywords (prospective studies [MeSH term] AND (fertility OR fecundity OR "time to pregnancy" OR urine OR pregnancy). Twenty studies were identified, of which 15 met our inclusion criteria. Among the reviewed studies, eligible women/couples from various populations were successfully recruited for study, with enrollment rates ranging from 42-100% despite intensive protocols including daily diaries. Length of follow-up varied from 3 to 12 months. Women provided urine (57-98%) and blood (86-91%) specimens and most male partners provided semen samples (94-100%). No evidence was identified to suggest differences in RADT exposure profiles with respect to pregnancy intentions. The utility of this design includes assessment of day specific exposures in relation to a spectrum of fecundity and fertility outcomes. Despite intensive protocols, women/couples have been successfully recruited and retained in prospective pregnancy studies underscoring the feasibility and utility of this design for assessing toxicants that may compromise human reproduction and development.