Maternal exposure to second-hand tobacco smoke and pregnancy outcome among couples undergoing assisted reproduction

• Published in: Human reproduction (Oxford) Vol. 22; no. 2; pp. 337 - 345
• Main Authors: Meeker, J.D., Missmer, S.A., Cramer, D.W., Hauser, R.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-02-2007; Oxford Publishing Limited (England)
• Subjects: Abortion, Spontaneous - etiology; Adult; Biological and medical sciences; Cotinine - urine; ETS; Female; Gynecology. Andrology. Obstetrics; Humans; IVF; Maternal Exposure - adverse effects; Medical sciences; Pregnancy; Pregnancy Outcome; Reproductive Techniques, Assisted; second-hand smoke; spontaneous abortion; Tobacco Smoke Pollution - adverse effects; IVF; spontaneous abortion; second-hand smoke; ETS; pregnancy; Tobacco smoke; Prognosis; Pregnancy disorders; Tobacco smoking; Couple; Assisted procreation; Exposure; ETS/IVF/pregnancy/second-hand smoke/spontaneous abortion; Abortion; Hand; In vitro fertilization embryo transfer; Vertebrata; Mammalia; Mother
• ISSN: 0268-1161; 1460-2350
• DOI: 10.1093/humrep/del406

BACKGROUND: Exposure to second-hand tobacco smoke is preventable, yet common. This study assessed relationships between maternal exposure to second-hand tobacco smoke and adverse pregnancy outcomes. METHODS: We measured cotinine (a biomarker of tobacco smoke) in urine from 921 women undergoing assisted reproductive technologies (ARTs) between 1994 and 1998. We also collected information on self-reported exposure to second-hand smoke at home or at work, in addition to parental smoking during the women’s childhood. RESULTS: In crude analysis, creatinine-adjusted cotinine levels were associated with a slight decrease in implantation rate among non-smoking women (11.1% in the lowest cotinine quintile versus 8.2% in the highest cotinine quintile; P = 0.13). However, in multivariate logistic regression, cotinine levels above the median were not associated with failed fertilization, failed implantation or spontaneous abortion, nor was there evidence of a dose–response relationship among cotinine quintiles. After excluding women in couples diagnosed with male factor infertility, there were increased odds of having a spontaneous abortion among non-smoking women who reported that both parents smoked while they were children growing up compared with women reporting that neither parent smoked [adjusted odds ratio (OR) = 4.35; 95% confidence interval (CI) = 1.04–18.1]. CONCLUSIONS: Female exposure to second-hand smoke as a child or in utero may be associated with an increased risk of spontaneous abortion in adulthood. However, this may be a chance finding due to multiple comparisons. Similar associations should be explored in additional studies with more refined estimates of childhood and in utero exposure to tobacco smoke.