# An internet-based preconception cohort study in North America and Denmark

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2020 · $98,203

## Abstract

ABSTRACT
Infertility and spontaneous abortion (SAB) are important public health problems, affecting up to 20% of
reproductive age couples. As couples increasingly postpone childbearing to the later reproductive years, many
seek infertility treatment, which has relatively low success rates, costs an estimated $5 billion per year in the
United States, and is associated with adverse pregnancy outcomes. Coping with the stress of infertility also
exacts a measurable emotional toll in affected couples. Identifying modifiable risk factors for infertility and SAB
is an important public health goal. Couples planning a pregnancy are notoriously difficult to recruit into
research studies using traditional methods. We have shown that enrollment and follow-up of pre-
conception couples via the internet in North America and Denmark is feasible, valid, and cost-efficient.
We propose to harmonize data from three interrelated prospective preconception cohort studies in Denmark
(Snart Gravid and Snart Foraeldre) and North America (PRESTO) to evaluate whether selected dietary factors
and medications influence female and male fecundity, and SAB risk. In order to increase our statistical power to
accomplish these aims, we will use our existing NICHD-supported web-based infrastructure to collect additional
data from 6,000 females and 2,000 of their male partners. There is limited evidence on whether commonly-used
medications, such as antibiotics, asthma drugs, antidepressants, and analgesics affect fertility and SAB, despite
the potentially large attributable risk due to increasing use of medications among couples of reproductive age.
In addition, there is a scarcity of research on dietary factors and reproduction from optimally-designed cohort
studies of couples actively trying to conceive. Dietary factors of interest include high glycemic load/index, soy,
and fish/seafood among females and red and processed meats, dairy, and trans-fatty acids among males. Most
studies of TTP and SAB are retrospective in design and prone to misclassification, left truncation, and selection
and recall biases. The few existing prospective studies of TTP and SAB are small and underpowered. The
harmonization of large preconception cohorts with similar designs will provide excellent power to evaluate a
broad range of hypotheses. Enrolling couples at the start of their pregnancy attempt can identify critical windows
of exposure susceptibility. The use of social media and health-related websites for recruitment is innovative and
extremely cost-effective relative to traditional methods. Inclusion of males is innovative because it allows for the
assessment of individual and joint effects of exposures in both partners, and permits better control for
confounding. Utilization of registry data will enable the collection of additional exposure and outcome data, data
validation, identification of those lost to follow-up, and assessment of selection bias and generalizability. This
will be the larges...

## Key facts

- **NIH application ID:** 10102149
- **Project number:** 3R01HD086742-05S1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** ELIZABETH E HATCH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $98,203
- **Award type:** 3
- **Project period:** 2016-09-14 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102149

## Citation

> US National Institutes of Health, RePORTER application 10102149, An internet-based preconception cohort study in North America and Denmark (3R01HD086742-05S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10102149. Licensed CC0.

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