Details:

Alternative Title:
J Womens Health (Larchmt)
Personal Author:
Rockhill, Karilynn ; Tong, Van T. ; Boulet, Sheree L. ; Zhang, Yujia ; Jamieson, Denise J. ; ... More +
Rockhill, Karilynn ; Tong, Van T. ; Boulet, Sheree L. ; Zhang, Yujia ; Jamieson, Denise J. ; Kissin, Dmitry M. Less -
Description:
Background:

Smoking near conception has adverse effects on pregnancy outcomes. We estimated the proportion of assisted reproductive technology (ART) cycles with smoking reported and associated clinical outcomes.

Methods:

We used a retrospective cohort study (2009–2013) using national data of ART cycles in the United States. We compared patient characteristics, infertility diagnoses, and treatment procedures by self-reported smoking in the 3 months before treatment. Using multivariable logistic regression accounting for clustering by state, clinic, and patient, we assessed adjusted odds ratios (aOR) and 95% confidence intervals (CI) between smoking and clinical outcomes: cycle cancellations among all cycles (cycle stopped before retrieval of eggs or transfer of embryos), treatment outcomes (implantation, ectopic pregnancy, intrauterine pregnancy, and live birth) among cycles with ≥1 fresh embryo transferred, and pregnancy outcomes (miscarriage, stillbirth, and live birth) among intrauterine pregnancies.

Results:

Smoking was reported in 1.9% of cycles. Higher proportions of cycles among smokers versus non-smokers were younger, non-Hispanic White, multigravida women and had tubal factor and male factor infertility diagnoses; lower proportions had diagnoses of diminished ovarian reserve and unexplained infertility, and used donor eggs. Smoking was associated with higher adjusted odds of cycle cancellation with no embryo transfer (aOR: 1.10; 95% CI: 1.00–1.21) and cancellations before fresh oocyte retrieval or frozen embryo transfer (1.11; 1.02–1.21). Associations between other clinical outcomes were nonsignificant.

Conclusions:

Over 12,000 ART cycles in the United States were exposed to smoking during 2009–2013; smoking increased the odds of cycle cancellation. Providers should encourage women to quit smoking before ART treatments.


Keywords:
[+]
Adult Assisted Reproductive Technologies Cigarette Smoking Cohort Studies Cycle Cancellations Female Humans Infertility Odds Ratio Pregnancy Pregnancy Outcome Pregnancy Outcomes Reproductive Techniques, Assisted Retrospective Studies Smoking Treatment Outcome
Source:
J Womens Health (Larchmt). 28(3):314-322
Pubmed ID:
30615563
Pubmed Central ID:
PMC6420368
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:9cd617ee7b4a833b9d243d10bd1f11ef358ab13f11b3517afd452307c028af63
Download URL:
https://stacks.cdc.gov/view/cdc/76949/cdc_76949_DS1.pdf
File Type:

Supporting Files

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