Association between traffic-related air pollution exposure and fertility-assisted births.

Previous studies have suggested that traffic-related air pollution is associated with adverse fertility outcomes, such as reduced fecundability and subfertility. The purpose of this research is to investigate if PM_2.5 exposure prior to conception or traffic-related exposures (traffic density and distance to nearest major roadway) at birth address is associated with fertility-assisted births. We obtained all live and still births from the Massachusetts state birth registry with an estimated conception date between January 2002 through December 2008. All births requiring fertility drugs or assisted reproductive technology were identified as cases. We randomly selected 2000 infants conceived each year to serve as a common control group. PM_2.5 exposure was assessed using 4 km spatial satellite remote sensing, meteorological and land use spatiotemporal models at geocoded birth addresses for the year prior to conception. The mean PM_2.5 level was 9.81 µg m^-3 (standard deviation = 1.70 µg m^-3), with a maximum of 14.27 µg m^-3. We calculated crude and adjusted fertility treatment odds ratios (ORs) and 95% confidence intervals (CI) per interquartile range of 1.72 µg m^-3 increase in PM_2.5 exposure. Our final analyses included 10 748 fertility-assisted births and 12 225 controls. After adjusting for parental age, marital status, race, maternal education, insurance status, parity, and year of birth, average PM_2.5 exposure during the year prior to conception was weakly associated with fertility treatment (OR: 1.01; 95% CI: 0.97, 1.05). Fertility-assisted births were inversely associated with traffic density (highest quartile compared to lowest quartile, OR: 0.92; 95% CI: 0.83, 1.02) and positively associated with distance from major roadway (OR per 100 m: 1.01; 95% CI: 1.00, 1.02) in adjusted analyses. We did not find strong evidence to support an adverse relationship between traffic-related air pollution exposure and fertility-assisted births.