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Background: The accuracy of birth outcome data provided by Internet‐based cohort study participants has not been well studied. Methods: We compared self‐reported data on birth characteristics in Pregnancy Study Online (PRESTO), an Internet‐based prospective cohort study of North American pregnancy planners, with birth certificate data. At enrolment, participants were aged 21‐45 years, attempting conception, and not using fertility treatment. Women completed online questionnaires during preconception, early and late pregnancy, and postpartum. We requested birth certificate data during 2014‐2019 from seven health departments in states with the most participants. After restricting to singleton births, we assessed specificity, sensitivity, and agreement comparing self‐reported data from postpartum questionnaires with birth certificate data for gestational age at delivery (GA) and birthweight (grams). Our primary measure of self‐reported GA (weeks) was calculated as [280‐(due date‐birth date)]/7. We used log‐binomial regression to assess predictors of agreement. Results: We linked 85% (771/909) of women in selected states. Median age of women was 30 years (range: 21‐42), 84% had ≥ 16 years of education, nearly 96% were married, 12% had household incomes <$50 000, 32% were parous, and 85% identified as non‐Hispanic White. Median recall interval was 6 months. Among those with self‐reported data, 89% reported the same GA as the birth certificate and 98% reported GA within 1 week of the birth certificate. Self‐report of preterm birth (GA < 37 weeks) agreed with information from birth certificates for 100% of women; sensitivity was 100%, and specificity was 99%. Self‐reported low birthweight (<2500 grams) agreed with birth certificates for 93% of women; sensitivity and specificity were 93% and ≥99%, respectively. Predictors of poorer agreement included higher parity and longer pregnancy attempt time for GA, and lower education and longer recall interval for birthweight. Conclusion: Self‐reported data on GA and birthweight from an Internet‐based cohort showed high accuracy compared with birth certificates. [ABSTRACT FROM AUTHOR]

Background: The human papillomavirus (HPV) vaccine was developed to prevent infection with strains of HPV that cause cervical cancer. While HPV infection has been associated with reduced semen quality and lower pregnancy rates in some studies, no studies have examined the relationship between HPV vaccination and fecundability. We hypothesize that HPV prevention via vaccination will protect fecundity.Methods: We analysed data from Pregnancy Study Online (PRESTO), a preconception cohort of North American pregnancy planners. Between 2013 and 2017, we followed 3483 female pregnancy planners and 1022 of their male partners for 12 months or until reported pregnancy, whichever came first. At baseline, participants reported whether they had been vaccinated against HPV and their age at vaccination. We estimated fecundability ratios (FR) and 95% confidence intervals (CI) using proportional probabilities models adjusted for sociodemographics, smoking, and abnormal Pap test before HPV vaccination (females only).Results: HPV vaccination was more prevalent among females (33.9%) than males (5.2%). There was little overall association between female vaccination (FR 0.98, 95% CI 0.90, 1.08) or male vaccination (FR 1.07, 95% CI 0.79, 1.46) and fecundability. Among females with a history of sexually transmitted infections or pelvic inflammatory disease (i.e. a group at high risk of exposure to HPV infection), those vaccinated against HPV had higher fecundability than those not vaccinated (FR 1.35, 95% CI 0.99, 1.86).Conclusion: Although HPV vaccination had little effect on fecundability overall, HPV vaccination was positively associated with fecundability among women with a history of sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Background: Little is known about potential health effects of eating organic food in relation to reproduction. Objective: We examined associations between organic food consumption and fecundability. Methods: Data were derived from a preconception cohort study of Danish couples trying to conceive (SnartForældre.dk, SF). Participants completed a baseline questionnaire on socio‐demographics, anthropometrics and lifestyle and a validated food‐frequency questionnaire, which included questions on proportions of organic food consumed within six food groups. Participants were followed up with bimonthly questionnaires for up to 12 months or until pregnancy. Analyses were restricted to 2061 participants attempting pregnancy for ≤6 cycles at enrollment and 1303 with <3 cycles. Fecundability ratios (FRs) and 95% confidence intervals (CI) were estimated by proportional probabilities regression models adjusted for potential confounders including age, lifestyle and socioeconomic factors. Associations were examined for vegetables, fruits, cereals, dairy products, eggs and meat, separately, and for the overall pattern of organic food consumption (organic sum score). Results: The final analytic sample comprised 2069 participants. In the full cohort, organic food consumption was not meaningfully associated with fecundability. Among participants <3 cycles of pregnancy attempt at study entry (n = 1303), the FR was 1.11 (95% CI 0.93, 1.33) for the category 'less than half', for 'more than half' the FR was 1.17 (95% CI 0.99, 1.38) and for 'almost everything' the FR was 1.12 (95% CI 0.97, 1.28). Conclusion: Higher consumption of organic foods was not meaningfully associated with fecundability, although slightly greater fecundability was seen among participants with <3 cycles of pregnancy attempt time. [ABSTRACT FROM AUTHOR]

Background We launched the Boston University Pregnancy Study Online ( PRESTO) to assess the feasibility of carrying out an Internet-based preconception cohort study in the US and Canada. Methods We recruited female participants age 21-45 and their male partners through Internet advertisements, word of mouth, and flyers. Female participants were randomised with 50% probability to receive a subscription to FertilityFriend.com ( FF), a web-based programme that collects real-time data on menstrual characteristics. We compared recruitment methods within PRESTO, assessed the cost-efficiency of PRESTO relative to its Danish counterpart ( Snart- Gravid), and validated retrospectively reported date of last menstrual period ( LMP) against the FF data. Results After 99 weeks of recruitment (2013-15), 2421 women enrolled; 1384 (57%) invited their male partners to participate, of whom 693 (50%) enrolled. Baseline characteristics were balanced across randomisation groups. Cohort retention was similar among those randomised vs. not randomised to FF (84% vs. 81%). At study enrolment, 56%, 22%, and 22% couples had been trying to conceive for <3, 3-5, and ≥6 months, respectively. The cost per subject enrolled was $146 (2013 US$), which was similar to our companion Danish study and half that of a traditional cohort study. Among FF users who conceived, >97% reported their LMP on the PRESTO questionnaire within 1 day of the LMP recorded via FF. Conclusions Use of the Internet as a method of recruitment and follow-up in a North American preconception cohort study was feasible and cost-effective. [ABSTRACT FROM AUTHOR]