BACKGROUND Polybrominated diphenyl ethers (PBDEs) have not been studied in relation to incident pregnancy loss in human populations, despite their ubiquitous exposure and purported reproductive toxicity. OBJECTIVES To investigate the association between preconception serum PBDE concentrations and incident pregnancy loss. METHODS A preconception cohort of 501 couples was followed while trying to become pregnant, and for whom serum concentrations of 10 PBDE congeners were measured using gas chromatography-high resolution mass spectrometry. Pregnancy was prospectively identified as a positive home pregnancy test on the day of expected menstruation. Incident pregnancy loss was defined for 344 singleton pregnancies as a conversion to a negative home pregnancy test, menses, or clinical diagnosis depending upon gestational age. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for individual and summed PBDEs and incident pregnancy loss, adjusting for relevant covariates and male partners' information. In sensitivity analyses, inverse probability weighting was used to account for couples not becoming pregnant and, thereby, not at risk for loss. RESULTS The incidence of prospectively observed pregnancy loss was 28%, and the serum concentrations of PBDE congeners in females were consistently associated with a higher hazard of incident pregnancy loss. Specifically, statistically significant hazard ratios (HRs) for incident pregnancy loss were observed for lower brominated PBDE congeners: 17 (HR 1.23; CI: 1.07-1.42), 28 (HR 1.25; CI: 1.03-1.52), 66 (HR 1.23; CI: 1.07-1.42), and homolog triBDE (HR: 1.25; CI: 1.05-1.49). Findings were robust to various model specifications explored in sensitivity analyses. CONCLUSIONS Maternal preconception serum concentrations of specific PBDE congeners may increase the hazard of incident pregnancy.

中文翻译：

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多溴联苯醚与意外流产：LIFE研究。

背景技术尽管多溴联苯醚（PBDEs）普遍存在并且据称具有生殖毒性，但尚未对人类中意外怀孕造成的多溴联苯醚（PBDEs）进行研究。目的探讨受孕前血清PBDE浓度与妊娠流产的关系。方法试图怀孕的前501对夫妇进行队列研究，并使用气相色谱-高分辨率质谱法测定了10对PBDE同源物的血清浓度。在预期的月经当天，已将妊娠前瞻性鉴定为阳性家庭妊娠试验。344例单胎妊娠的事件妊娠损失定义为根据妊娠年龄转换为阴性家庭妊娠试验，月经或临床诊断。使用Cox比例风险模型估算个体和累加的PBDEs的风险比（HRs）和95％置信区间（CIs）以及意外怀孕损失，并根据相关协变量和男性伴侣的信息进行调整。在敏感性分析中，使用了逆概率加权来说明未怀孕的夫妇，因此，没有失去风险。结果前瞻性观察到的妊娠流失发生率为28％，并且女性中PBDE同系物的血清浓度与发生妊娠流产的较高危险性相关。具体而言，观察到较低的溴化多溴二苯醚同系物在妊娠中丢失的统计学显着危险比（HR）：17（HR 1.23； CI：1.07-1.42），28（HR 1.25； CI：1.03-1.52），66（HR 1.23； CI：1.07-1.42）和同系物三溴二苯醚（HR：1.25； CI：1.05-1.49）。该结果对于敏感性分析中探索的各种模型规格均具有鲁棒性。结论特定PBDE同类物的孕妇孕前血清浓度可能会增加发生妊娠的危险。