Human reproduction is declining over the past decades. Factors related to urban living environment such as pollutant exposure, built environment, and lifestyles may contribute to the declined fertility. No consensus has been reached, however, partially due to the complexity of human reproductive system. Investigating etiology of compromised human reproduction is a complex as adverse reproductive events are highly correlated within individuals. For example, women with irregular menstrual cycles are more likely to experience infertility, miscarriage, adverse birth outcomes, and early menopause. These compromised reproductive events have all been separately linked to adverse health outcomes in later life such as cardiovascular disease and premature death in very recent research. Current research analyzes each reproductive event separately, without a holistic framework in investigating shared risk factors and mechanisms of incidence. Thus, we aim to identify patterns of compromised reproduction among female over the lifecourse from menarche to menopause. We subsequently investigated the upstream causes and downstream later life health consequences of the identified compromised patterns. We hypothesize that the compromised reproduction may be attributable to urban living environment and can collectively increase risks of later life chronic diseases and mortality. In this study, we aim to
1. identify clusters/patterns of compromised reproduction events among women from early age at menarche, PCOS, infertility, adverse birth outcomes, to early age at menopause, using advanced machine learning algorithms.
2. examine urban living environment exposure with risks of compromised reproduction patterns, from the perspective of exposome and causal inference framework.
3. examine the associations between compromised reproduction pattern and later life chronic disease risks such as CVD, cancer, dementia, and premature death, and further identify modifiable factors.
