title: Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites. II. Female reproductive disorders.
abstract: Members of the workgroup on female reproductive disorders discussed methods to evaluate five principal functions: menstrual dysfunction, infertility, pregnancy loss, lactation disorders, and pregnancy complications. To test each function, a nested strategy was considered, based on progressive levels of effort available to conduct field investigations. This strategy was analogous to the three-tier classification of biomarkers used by other workshops. The lowest level of effort, corresponding to Tier 1, consists only of questionnaires, diaries, and reviews of maternal and infant medical records. The medium level of effort (Tier 2) collects data from questionnaires and diaries, and some biologic specimens. Suggested laboratory analyses included measurement of progesterone in saliva and several glycoprotein hormones in urine that evaluate menstrual dysfunction, infertility, and pregnancy loss. The highest level of effort (Tier 3) involves prospective collection of diary information and simultaneous collection of biological specimens.
authors.affiliation: Georgetown University Medical Center, Washington, DC, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Scialli
authors.forename: S H
authors.initials: SH
authors.lastname: Swan
authors.forename: R W
authors.initials: RW
authors.lastname: Amler
authors.forename: D D
authors.initials: DD
authors.lastname: Baird
authors.forename: B
authors.initials: B
authors.lastname: Eskenazi
authors.forename: G
authors.initials: G
authors.lastname: Gist
authors.forename: M C
authors.initials: MC
authors.lastname: Hatch
authors.forename: J S
authors.initials: JS
authors.lastname: Kesner
authors.forename: G K
authors.initials: GK
authors.lastname: Lemasters
authors.forename: M
authors.initials: M
authors.lastname: Marcus
authors.forename: M E
authors.initials: ME
authors.lastname: Paul
authors.forename: P
authors.initials: P
authors.lastname: Schulte
authors.forename: Z
authors.initials: Z
authors.lastname: Taylor
authors.forename: A J
authors.initials: AJ
authors.lastname: Wilcox
authors.forename: C
authors.initials: C
authors.lastname: Zahniser
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006256:Hazardous Waste / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000453:epidemiology* / Q000209:etiology; D008599:Menstruation Disturbances / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology
chemical_list: D006256:Hazardous Waste