Hum. Reprod. Advance Access originally published online on October 19, 2006
Human Reproduction 2007 22(2):337-345; doi:10.1093/humrep/del406
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Maternal exposure to second-hand tobacco smoke and pregnancy outcome among couples undergoing assisted reproduction
1 Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 2 Obstetrics, Gynecology and Reproductive Science, Brigham and Women’s Hospital, Harvard Medical School 3 Department of Environmental Health, Harvard School of Public Health and 4 Vincent Memorial Obstetrics and Gynecology Service, Andrology Laboratory and In Vitro Fertilization Unit, Massachusetts General Hospital, Boston, MA, USA
5 To whom correspondence should be addressed at: Department of Environmental Health Sciences, University of Michigan School of Public Health, M6226 SPH II, 109 S. Observatory St., Ann Arbor, MI 48109, USA. E-mail: meekerj{at}umich.edu
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.
Key words: ETS/IVF/pregnancy/second-hand smoke/spontaneous abortion
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  J. D. Meeker, S. A. Missmer, A. F. Vitonis, D. W. Cramer, and R. Hauser Risk of Spontaneous Abortion in Women with Childhood Exposure to Parental Cigarette Smoke Am. J. Epidemiol., September 1, 2007; 166(5): 571 - 575. [Abstract] [Full Text] [PDF]
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