{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:50:03Z","timestamp":1792684203667,"version":"4.5.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Excessive exposure to PM2.5 can be detrimental to reproductive health. The objective of this study was to investigate the potential associations between ambient PM2.5 exposure during different periods and negative pregnancy outcomes, such as miscarriage and preterm birth, in patients who underwent assisted reproductive technology (ART).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study examined the outcomes of 2,839 infertile women aged \u2264 45 years who underwent their first fresh or frozen-thawed embryo transfer at the Shanghai First Maternity and Infant Hospital between April 2016 and December 2019. Satellite data were used to determine the daily average levels of PM2.5, and exposure was categorized as excessive if it exceeded the WHO\u2019s interim target 2 level of 50 \u00b5g\/m<jats:sup>3<\/jats:sup>. The analysis was conducted separately for seven different periods. Our study used multinomial logistic regression models to explore the potential associations between PM2.5 exposure and adverse pregnancy outcomes. Sensitivity analysis was conducted by excluding women who underwent blastocyst transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Daily PM2.5 exposure exceeding the threshold (50 \u00b5g\/m<jats:sup>3<\/jats:sup>) was associated with an increased risk of miscarriage during the period after confirmation of clinical pregnancy or biochemical pregnancy, with adjusted odds ratios (AORs) of 2.22 (95% CI 1.75-2.81) and 2.23 (95% CI 1.68-2.96), respectively. Moreover, for each increase of 10 \u00b5g\/m<jats:sup>3<\/jats:sup> above the threshold for PM2.5, there was a 46% elevated risk of preterm birth (AOR = 1.46, 95% CI 1.09-1.94) during the period after the confirmation of clinical pregnancy and a 61% elevated risk of preterm birth (AOR = 1.61, 95% CI 1.16-2.23) during the period after the confirmation of biochemical pregnancy. Our stratified analyses revealed that women with an endometrial thickness &amp;lt;11 mm or who underwent frozen embryo transfer were more vulnerable to PM2.5 exposure, leading to higher rates of preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Excessive PM2.5 exposure after biochemical pregnancy or clinical pregnancy was associated with increased risks of preterm birth and miscarriage among women who underwent ART.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1460976","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T08:24:17Z","timestamp":1737966257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations of maternal PM2.5 exposure with preterm birth and miscarriage in women undergoing in vitro fertilization: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Miaoxin","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoyu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gengze","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andong","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Bukulmez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haidong","family":"Kan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lap Ah","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Teng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1803222115","article-title":"Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter","volume":"115","author":"Burnett","year":"2018","journal-title":"Proc Natl Acad Sci U.S.A"},{"key":"B2","doi-asserted-by":"publisher","first-page":"128436","DOI":"10.1016\/j.chemosphere.2020.128436","article-title":"Effects of PM(2.5) exposure on reproductive system and its mechanisms","volume":"264","author":"Wang","year":"2021","journal-title":"Chemosphere"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-014-3458-7","article-title":"Maternal exposure to fine particulate matter (PM2.5) and pregnancy outcomes: a meta-analysis","volume":"22","author":"Zhu","year":"2015","journal-title":"Environ Sci Pollut Res Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"106231","DOI":"10.1016\/j.envint.2020.106231","article-title":"Association between exposure to airborne particulate matter less than 2.5 \u03bcm and human fecundity in China","volume":"146","author":"Li","year":"2021","journal-title":"Environ Int"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1097\/EE9.0000000000000036","article-title":"Ambient air pollution exposure and fecundability in women undergoing in vitro fertilization. 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