Hum. Reprod. Advance Access published online on October 19, 2006
Human Reproduction, doi:10.1093/humrep/del406
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1 Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
* To whom correspondence should be addressed. 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.
Received June 12, 2006
Revised September 13, 2006
Accepted September 20, 2006
Article
Maternal exposure to second-hand tobacco smoke and pregnancy outcome among couples undergoing assisted reproduction
J.D. Meeker 1 *, S.A. Missmer 2, D.W. Cramer 2, and R. Hauser 3
2 Obstetrics, Gynecology and Reproductive Science, Brigham and Women’s Hospital, Harvard Medical School
3 Department of Environmental Health, Harvard School of Public Health; Vincent Memorial Obstetrics and Gynecology Service, Andrology Laboratory and In Vitro Fertilization Unit, Massachusetts General Hospital, Boston, MA, USA
J.D. Meeker, E-mail: meekerj{at}umich.edu
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