Durational Exposure to Particulate Matter and Changes in Fertility Intentions: A Study of Adults in China.

Objective: The effects of prolonged exposure to persistently elevated atmospheric pollutants, commonly termed air pollution waves, on fertility intentions remain inadequately understood. This study aims to investigate the association between particulate matter (PM) exposure and fertility intentions.

Methods: In this nationwide cross-sectional study, we analyzed data from 10,747 participants (5496 females and 5251 males). PM waves were defined as periods lasting 3‒6 consecutive days during which the daily average concentrations exceeded China's Ambient Air Quality Standards Grade II thresholds (PM_2.5 > 75 μg/m³ and PM₁₀ > 150 μg/m³). We employed multivariate logistic regression models to assess the association between exposure to PM waves and fertility intentions.

Results: Significant inverse associations were detected between exposure to PM_2.5 wave events (characterized by concentrations exceeding 75 μg/m³ for durations of 4‒6 days, P < 0.05) and PM₁₀ wave events (defined as concentrations exceeding 150 μg/m³ for 6 consecutive days, P < 0.05) and fertility intentions among females. In contrast, neither the PM_2.5 wave nor the PM₁₀ wave events demonstrated statistically significant correlations with fertility intentions in males (P > 0.05 for all comparisons). The potentially susceptible subgroup was identified as females aged 20-30 years.

Conclusions: Our results provide the first evidence that PM_2.5 and PM₁₀ waves are associated with a reduction in female fertility intentions, offering critical insights for the development of public health policies and strategies aimed at individual protection.