Rates of Spontaneous Abortion and Air Pollution.

[NNadir]

The paper I will discuss in this post is this one: Amelia K. Wesselink, Kipruto Kirwa, Perry Hystad, Joel D. Kaufman, Adam A. Szpiro, Mary D. Willis, David A. Savitz, Jonathan I. Levy, Kenneth J. Rothman, Ellen M. Mikkelsen, Anne Sofie Dam Laursen, Elizabeth E. Hatch, Lauren A. Wise, Ambient air pollution and rate of spontaneous abortion, Environmental Research, Volume 246, 2024, 118067.

The authors are from multiple institutions in the United States.

As, rightly, a focus of this week's convention has been on Women's Health and the Republican's efforts to seize women's internal organs as state property, the issue of abortion and abortion rights has been on my mind.

I am, more or less, an atheist. The origin of the universe is, of course, a mystery of me - something I find rather pleasing in some sense, even with my subscription to the universe is about to expire - but I'm completely certain that the source of it has nothing to do with an anthropomorphic being or beings who supervise everything.

However, if I did believe in an anthropomorphic God or gods, I would have to say that the evidence is rather substantial that that putatively powerful omniscient and controlling person (or quasi-person) might well be considered to be an abortionist. Many pregnancies end in spontaneous abortion, aka, euphemistically "miscarriages," and is surely statistically unlikely to be affected by prayer.

I know this from direct experience. My wife had a few spontaneous abortions (miscarriages) during our first efforts to conceive; it wasn't a major thing and only slightly extended the fun. In no time at all after we decided we wanted to be parents - for a long time in our marriage we didn't want to be parents - we did become parents. It worked out well; I'm a happy father of two fine young men of whom I am very proud.

Anyway...

I was thinking about this topic because of the emphasis on women's health, and I am always thinking about dangerous fossil fuel waste, both in the form of chemotoxins and in the form of the extreme global heating now being observed on a planetary scale.

So I went over to Google Scholar and poked around, and picked the paper linked above on the topic.

The abstract of the paper, which is available to the public, I think, indicates that up to 30% of conceptions end in "SAB" (spontaneous abortion), the references in the text suggest some slightly lower numbers, but indicates that real data is difficult to come by as most people don't report "SAB." We didn't, but just went back to rolling in the hay as they say.

From the first paragraph introductory text in the full paper:

Spontaneous abortion (SAB), or miscarriage, is defined as the loss of an intrauterine pregnancy before viability ( less than 20 weeks of gestation) (Quenby et al., 2021). Approximately 15% of recognized pregnancies, (Quenby et al., 2021) but up to 30% of pregnancies overall (Wilcox et al., 1988), end in SAB, and SAB incidence appears to be increasing in several countries (Rossen et al., 2018; Li et al., 2016; Rasmark Roepke et al., 2019). SAB has immediate physical and psychological consequences and is associated with increased risk of future obstetrical complications (Saraswat et al., 2010), cardiovascular disease (Kyriacou et al., 2022), and long-term mental health disorders (Farren et al., 2020). Despite the high population burden of SAB, few modifiable risk factors have been identified, thus limiting opportunities for prevention...

The next paragraph is a list of references to people thinking that air pollution may be a contributing factor, and the authors' intention is to add to that literature.

It's a difficult topic to measure. The authors note:

...SAB is a challenging outcome to measure, as it is not directly observable and often occurs early in pregnancy, sometimes before pregnancy recognition (Wilcox et al., 1988). Studies that enroll couples during the preconception period are more likely to capture early SAB than studies that recruit during pregnancy. Most of the existing preconception cohort studies investigating air pollution and SAB risk have been conducted among couples undergoing in vitro fertilization (Choe et al., 2018; Legro et al., 2010; Perin et al., 2010a, 2010b; Gaskins et al., 2020). These studies have the unique advantage of being able to identify precise critical windows of exposure, but tend to have small sample sizes and may not be generalizable to populations trying to conceive spontaneously. A 2022 review emphasized the need for large detailed preconception cohort studies of air pollution and SAB (Ha et al., 2022).

In the present study, we estimated the effect of residential ambient exposure to PM2.5, NO2, and O3 on SAB incidence in a large prospective preconception cohort study of couples from across the United States (U.S.) and Canada...

The authors describe the methods of their studies, which involved questionnaires filled out with the study subjects, numbering in roughly 5000:

2. Methods
Study design. We used data from Pregnancy Study Online (PRESTO), an internet-based prospective preconception cohort study (Wise et al., 2015). Enrollment began in June 2013 and is ongoing. Eligible participants self-identified as female, were aged 21–45 years, resided in the U.S. or Canada, and were trying to conceive without use of fertility treatments at enrollment. Participants completed a baseline questionnaire on sociodemographic characteristics, lifestyle factors, and reproductive and medical histories. They then completed follow-up questionnaires every 8 weeks for up to 12 months to ascertain information on pregnancy status and to update exposure information. Participants who conceived completed additional questionnaires during early (?8 weeks' gestation) and late pregnancy (?32 weeks’ gestation) and at 6 months postpartum. On all questionnaires, participants were asked to update their residential address if they had moved. In the current analysis, we used data from 4643 U.S. and 851 Canadian participants who enrolled in the study between June 2013 and April 2019, who conceived during 12 months of follow-up, and whose residential addresses could be geocoded. The study protocol was approved by the institutional review board at the Boston University Medical Campus and all participants provided informed consent.

Outcome assessment. We collected information on pregnancy and pregnancy outcomes
on follow-up and pregnancy questionnaires. On follow-up questionnaires, participants reported the date of their last menstrual period (LMP), whether they were currently pregnant, and whether they had experienced a miscarriage (or chemical pregnancy), ectopic pregnancy, induced abortion, or blighted ovum since their previous questionnaire. We asked participants when and how often they used home pregnancy tests and the result of each test (positive or negative). Participants who were currently pregnant at the time they completed the follow-up questionnaire were directed to the early pregnancy questionnaire, on which they reported whether they had experienced any of the above pregnancy losses since their previous questionnaire, the date of their first positive pregnancy test, and how their pregnancy was confirmed (e.g., home pregnancy test, blood test in a doctor's office). Losses that occurred after completion of the early pregnancy questionnaire were identified on the late pregnancy questionnaire...

The pollutants studied were ozone (O₃), NO₂, and fine particulates (PM_2.5).

Surprisingly, to me at least, the authors found no evidence of a relationship between these pollutants and spontaneous abortion among the US subjects, and slight, possibly statistically invalid, relationships between them in the Canadian subjects.

This study suggests a null result.

By the way, I think the publication of null results is a wonderful thing; we need more of that.

Of course, even if air pollution doesn't terminate pregnancies, it does kill functional human beings in vast numbers. This is well known and is a subject on which I often harp in my quixotic quest to oppose dangerous fossil fuels.

Irrespective of whether there is a "God" and whether He, She, or It is an abortionist, there is no moral justification for declaring women's internal organs State property. I loved the excerpted video played at the convention featuring our nominee questioning that asshole political abusive pig Brett Kavanaugh during his confirmation hearings of whether he knew of any laws regulating men's bodies. It said all you need to know.

Then of course, there's this wonderful video of the perjuring pig at his hearing.

[erronis]

1. You always get my brain a-churning. That's a good thing except while trying to sleep.

In my limited experience as a participant in the attempts to create a new human child, the 30% SAB seems about right. Of course there are some women who just can't carry a fetus to birth, but there are many who try more than once and succeed eventually. Each miscarriage is heart-rending.

I wonder what is the percentage of still births to non-human species. I would think that other species have many unsuccessful births, also.

[Clouds Passing]

2. Sounds to me like little Brett has a substance abuse problem 😳 defensive much about your beer Brett?

SAB is a painful event physically and psychologically. There are many causes, including autoimmune diseases, infections and chronic stress. Bad air quality may be found to be a factor, toxins are responsible for causing or exacerbating many illnesses.

https://www.ncbi.nlm.nih.gov/books/NBK560521/