Smoking and recurrent pregnancy loss: A cohort study of 2829 women.

Autor: Hviid KVR; Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Rigshospitalet Dept. Fertility & Hvidovre Hospital, Dept. of Obstetrics and Gynecology, Kettegaard Alle 30, Hvidovre DK-2650, Denmark; Dept. of Obstetrics and Gynecology, Hvidovre Hospital, Kettegaard Alle 30, Hvidovre DK-2650, Denmark. Electronic address: Kathrine.vauvert.roemmelmayer.hviid@regionh.dk., Bliddal S; Dept. of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark., El Issaoui M; Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Rigshospitalet Dept. Fertility & Hvidovre Hospital, Dept. of Obstetrics and Gynecology, Kettegaard Alle 30, Hvidovre DK-2650, Denmark., Krog MC; Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Rigshospitalet Dept. Fertility & Hvidovre Hospital, Dept. of Obstetrics and Gynecology, Kettegaard Alle 30, Hvidovre DK-2650, Denmark; Dept. of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark., Kolte AM; Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Rigshospitalet Dept. Fertility & Hvidovre Hospital, Dept. of Obstetrics and Gynecology, Kettegaard Alle 30, Hvidovre DK-2650, Denmark; Dept. of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen N DK-2200, Denmark., Nielsen HS; Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Rigshospitalet Dept. Fertility & Hvidovre Hospital, Dept. of Obstetrics and Gynecology, Kettegaard Alle 30, Hvidovre DK-2650, Denmark; Dept. of Obstetrics and Gynecology, Hvidovre Hospital, Kettegaard Alle 30, Hvidovre DK-2650, Denmark; Dept. of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen N DK-2200, Denmark.
Jazyk: angličtina
Zdroj: Journal of reproductive immunology [J Reprod Immunol] 2024 Aug; Vol. 164, pp. 104257. Date of Electronic Publication: 2024 May 16.
DOI: 10.1016/j.jri.2024.104257
Abstrakt: Smoking during pregnancy is associated with negative reproductive outcome. Less is known about the impact of smoking or previous smoking in women with recurrent pregnancy loss (RPL) which this study aimed to investigate. We included all women <42 years (n=2829) referred to a RPL unit at Copenhagen University Hospital between January 2000 and December 2021 in the cohort with follow-up until June 2022. Patients were categorized as 'smokers at time of referral', 'never-smokers' or 'former smokers'. The main outcomes were pregnancy history prior to referral, prospective pregnancy rate, live birth rate, rates of ectopic pregnancy, and stillbirth. At referral, smokers (n=373) were on average 2.0 years younger (P<0.001) and had experienced significantly more pregnancy losses (P<0.001), and stillbirths (P=0.01) compared to never-smokers (n=2100). Former smokers had a higher risk of stillbirth prior to referral compared to never-smokers but no differences in pregnancy rate or other outcomes. Prospective pregnancy rates were lower for smokers compared with never-smokers (71.8% vs. 77.5%, P=0.02). Live birth rate was 58.0% for the 243 women who smoked at referral compared to 61.4% for the 1488 never-smokers (P=0.32). Stillbirth and ectopic pregnancies were significantly more common for smokers (2.8% vs. 0.4%, P=0.01; 6.0% vs. 2.0%, P<0.008). Women with RPL who smoked at referral were referred younger with a higher number of previous pregnancy losses and stillbirths compared with never-smokers. Fewer smokers achieved a pregnancy after referral but those who did had a similar live birth rate compared to never-smokers, although stillbirths and ectopic pregnancies were more common.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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