Evidence for effects of PM2.5 chemical constituent exposures during the periovulatory period on pregnancy complications was limited. We explored the associations of maternal PM2.5 and constituent exposures from the 12th week before to 4th week after ovulation with human clinically recognized early pregnancy loss (CREPL). From July 2017 to January 2024, 828 CREPL and 828 normal early pregnancy (NEP) participants were recruited in Tianjin, China. Daily residential exposures to PM2.5 and five main constituents of all participants were estimated using data of the Tracking Air Pollution in China platform. Nonlinear and linear associations between weekly pollutant exposures and CREPL were estimated using conditional logistic regression models combined with distributed lag nonlinear and distributed lag models, respectively. The risk of CREPL increased with per 10 μg/m³ increment in PM2.5 and per 1 μg/m³ increment in sulfate, nitrate, and ammonium exposures during specific weeks from the 5th week before to 2nd week after ovulation, with the largest OR (95% CI) of CREPL associated with PM2.5, sulfate, nitrate, and ammonium being 1.73 (1.07, 2.78), 1.71 (1.18, 2.46), 1.80 (1.12, 2.90), and 1.61 (1.01, 2.56), respectively. CREPL was positively associated with the 10th to 90th percentiles exposure to organic matter during the 2nd and 3rd week after ovulation. In analyses for constituent residuals, the five constituents were all independently related to CREPL, with organic matter being the highest risk constituent, and nitrate and ammonium affecting at the initial stage of preantral follicle development. In conclusion, periovulatory PM2.5 and constituent exposures were associated with increased risk of CREPL. Women planning a pregnancy are advised to take exposure precautions starting from the follicular development period.
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