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We investigated the association between air pollution and changes in ovarian follicles, anti-mullerian hormone (AMH) levels, the occurrence of necroptosis cell death by activation of receptor-interacting protein kinase 3 (RIPK3) and, the activation of mixed lineage kinase domain-like (MLKL) proteins. Forty-two female Wistar rats were divided into three groups of 14 each, which were exposed to real-ambient air, filtered air and purified air (control) in two periods of 3 and 5 months. The results showed that the number of ovarian follicles decreased in the group exposed to real-ambient air versus the control group (P < 0.0001). The trend of age-related AMH changes with respect to exposure to air pollutants was affected and its levels decreased after 3 months of exposure. The MLKL increased in the group exposed to the real-ambient air compared to the control group (P = 0.033). Apparently long-term exposure to air pollution can reduce ovarian reserves.

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Anti-mullerian hormone (AMH) concentration is a marker of ovarian reserve that decreases with age. However, a decrease in AMH may occur more rapidly under the influence of environmental factors. The present study investigated the association between long-term exposure to ambient air pollutants with serum concentrations of AMH and the AMH rate of decline. This study included 806 women with median age of 43 years (interquartile range: 38-48) participating in the Tehran Lipid and Glucose Study (TLGS) that were followed from 2005 to 2017. The AMH concentration and the demographic, anthropometric, and personal health parameters of the study participants were obtained from the TLGS cohort database. Air pollutant data were collected from the monitoring stations and the individual exposures were estimated by previously developed land use regression (LUR) models. Multiple linear regression analysis was used to estimate linear relationships between the air pollutant exposures and serum concentration of AMH and with the AMH declination rate. The results show no statistically significant associations between exposures to any of the air pollutants (including PM10, PM2.5, SO2, NO, NO2, NOX, and benzene, toluene, ethylbenzene, p-xylene, m-xylene, o-xylene (BTEX), and total BTEX) with serum concentration of AMH. Compared to the first tertile, no statistically significant associations were observed between the second or third tertiles of air pollutants, with the AMH rate of decline. In this study, we did not find significant association between air pollution and AMH in middle age women in Tehran, Iran. Future work may study such associations in younger women.

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Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m3 increase at lags of 6 and 7 days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO2 at a lag of 4 days. PM2.5 and PM10 were associated with cerebrovascular disease admissions in females aged 16-65 years and 16 years and younger for each 10 µg/m3 increase, respectively. Short-term exposure to SO2, NO2, and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution.

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INTRODUCTION: Biological, environmental, inter- and intrapersonal changes during the antenatal period can result in anxiety and stress in pregnant women. It is pivotal to identify potential stressors and prevent their foetal and maternal consequences. The present study was conducted to validate and examine the factor structure of the Farsi version of the Pregnancy Worries and Stress Questionnaire (PWSQ). METHODS: In 2015, 502 Iranian healthy pregnant women, referred to selected hospitals in Tehran for prenatal care at 8-39 weeks of pregnancy, were recruited through a randomized cluster sampling. The PWSQ was translated into Farsi, and its validity and reliability were examined using exploratory factor analysis by SPSS version 21. RESULTS: The content validity of items on the PWSQ was between 0.63-1. The content validity index for relevance, clarity and simplicity were 0.92, 0.98, and 0.98, respectively, with a mean of 0.94. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.863. Test-retest reliability showed high internal consistency (α=0.89; p<0.0001). CONCLUSION: The psychometric evaluation and exploratory factor analysis showed that the translated questionnaire is a valid and reliable tool to identify stress in Iranian pregnant women. Application of the questionnaire can facilitate the diagnosis of stress in pregnant women and assist health care providers in providing timely support and minimizing negative outcomes of stress and anxiety in pregnant women and their infants.

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BACKGROUND AND OBJECTIVES: Pregnant women tend to experience anxiety and stress when faced with the changes to their biology, environment and personal relationships. The identification of these factors and the prevention of their side effects are vital for both mother and fetus. The present study was conducted to validate and to examine the factor structure of the Persian version of the Pregnancy's Worries and Stress Questionnaire. MATERIALS AND METHODS: The 25-item PWSQ was first translated by specialists into Persian. The questionnaire's validity was determined using face, content, criterion and construct validity and reliability of questionnaire was examined using Cronbach's alpha. Confirmatory factor analysis was performed in AMOS and SPSS 21. Participants included healthy Iranian pregnant women (8-39 weeks) who refer to selected hospitals for prenatal care. Hospitals included private, social security and university hospitals and selected through the random cluster sampling method. FINDINGS: The results of validity and reliability assessments of the questionnaire were acceptable. Cronbach's alpha calculated showed a high internal consistency of 0.89. The confirmatory factor analysis using the c2, CMIN/DF, IFI, CFI, NFI and NNFI indexes showed the 6-factor model to be the best fitted model for explaining the data. CONCLUSION: The questionnaire was translated into Persian to examine stress and worry specific to Iranian pregnant women. The psychometric results showed that the questionnaire is suitable for identifying Iranian pregnant women with pregnancy-related stress.

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