title: Exposure to Power-Frequency Magnetic Fields and the Risk of Infertility and Adverse Pregnancy Outcomes: Update on the Human Evidence and Recommendations for Future Study Designs.
abstract: Infertility and adverse pregnancy outcomes are significant public health concerns with global prevalence. Over the past 35 years, research has addressed whether exposure to power-frequency magnetic fields is one of the etiologic factors attributed to these conditions. However, no apparent authoritative reviews on this topic have been published in the peer-reviewed literature for nearly 15 years. This review provides an overview and critical analysis of human studies that were published in the peer-reviewed literature between 2002 and July 2015. Using PubMed, 13 epidemiology studies published during this time frame that concern exposure to magnetic fields and adverse prenatal (e.g., miscarriage), neonatal (e.g., preterm birth or birth defects), and male fertility (e.g., poor semen quality) outcomes were identified. Some of these studies reported associations whereas others did not, and study design limitations may explain these inconsistencies. Future investigations need to be designed with these limitations in mind to address existing research gaps. In particular, the following issues are discussed: (1) importance of selecting the appropriate study population, (2) need for addressing confounding due to unmeasured physical activity, (3) importance of minimizing information bias from exposure measurement error, (4) consideration of alternative magnetic field exposure metrics, and (5) implications and applications of personal exposure data that are correlated within female-male couples. Further epidemiologic research is needed, given the near ubiquitous exposures to power-frequency magnetic fields in the general population.
authors.affiliation: a Department of Environmental Health Sciences , University of Michigan School of Public Health , Ann Arbor , Michigan , USA.|b Center for Occupational & Environmental Health Risk Assessment , Exponent, Inc ., Oakland , California , USA.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Lewis
authors.affiliation: c Departments of Environmental Health and Epidemiology , Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA.|d Vincent Memorial Obstetrics and Gynecology Service , Massachusetts General Hospital , Boston , Massachusetts , USA.
authors.forename: Russ
authors.initials: R
authors.lastname: Hauser
authors.affiliation: a Department of Environmental Health Sciences , University of Michigan School of Public Health , Ann Arbor , Michigan , USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Maynard
authors.affiliation: a Department of Environmental Health Sciences , University of Michigan School of Public Health , Ann Arbor , Michigan , USA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Neitzel
authors.affiliation: e Department of Biostatistics , University of Michigan School of Public Health , Ann Arbor , Michigan , USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: f Electric Power Research Institute , Palo Alto , California , USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kavet
authors.affiliation: a Department of Environmental Health Sciences , University of Michigan School of Public Health , Ann Arbor , Michigan , USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Meeker
mesh_terms: D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D047109:Fetal Development / Q000528:radiation effects*; D006801:Humans; D007231:Infant, Newborn; D007246:Infertility / Q000209:etiology*; D060526:Magnetic Fields / Q000009:adverse effects*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects; D012107:Research Design; D012306:Risk