Ashford Kristin, Rayens Emily, Wiggins Amanda T, Kay Rayens Mary, Sayre Molly Malany, O'Brien John
University of Kentucky Perinatal Research and Wellness Center, College of Nursing, Lexington, KY, USA.
Department of Infectious Disease, University of Georgia, Athens, GA, USA.
SAGE Open Nurs. 2018 Nov 9;4:2377960818806285. doi: 10.1177/2377960818806285. eCollection 2018 Jan-Dec.
To evaluate the association of biochemically validated prenatal tobacco use with serum progesterone and estradiol in the second trimester of pregnancy, controlling for demographic and personal factors.
This secondary analysis of a multicenter longitudinal study included 114 women with singleton pregnancies. Multiple regression analysis assessed whether prenatal tobacco use was related to hormone levels during the second trimester, controlling for covariates (age, body mass index, and race or ethnicity, with gestational age added to subsequent models).
In the initial regressions, tobacco users had significantly lower progesterone level compared with nonsmokers ( = .037), while estradiol was unrelated to prenatal tobacco use. Women with greater body mass index also had significantly lower progesterone ( = .028), but body mass index was unrelated to estradiol. With gestational age as an additional covariate, prenatal tobacco use was no longer a significant predictor of progesterone, but both body mass index and gestational age were significant ( = 10.6, < .001, = 0.35). For estradiol, the overall regression of estradiol on age, body mass index, and race or ethnicity was not significant ( = 1.2, = .31). With gestational age added to the model, the overall model was significant ( = 7.2, < .001, = 0.27).
This study provides additional evidence that prenatal tobacco use may influence lower serum progesterone during the second trimester. This is of particular concern given the link between depressed progesterone activity and risk for preterm birth.
在控制人口统计学和个人因素的情况下，评估经生化验证的孕期吸烟与孕中期血清孕酮和雌二醇之间的关联。
这项对多中心纵向研究的二次分析纳入了114名单胎妊娠女性。多元回归分析评估了孕期吸烟是否与孕中期的激素水平相关，并控制了协变量（年龄、体重指数、种族或民族，后续模型中加入了孕周）。
在初始回归分析中，与不吸烟者相比，吸烟女性的孕酮水平显著较低（P = 0.037），而雌二醇与孕期吸烟无关。体重指数较高的女性孕酮水平也显著较低（P = 0.028），但体重指数与雌二醇无关。将孕周作为额外的协变量后，孕期吸烟不再是孕酮的显著预测因素，但体重指数和孕周均具有显著性（F = 10.6，P < 0.001，R² = 0.35）。对于雌二醇，雌二醇对年龄、体重指数和种族或民族的总体回归不显著（F = 1.2，P = 0.31）。在模型中加入孕周后，总体模型具有显著性（F = 7.2，P < 0.001，R² = 0.27）。
本研究提供了额外的证据，表明孕期吸烟可能会影响孕中期血清孕酮水平降低。鉴于孕酮活性降低与早产风险之间的联系，这尤其令人担忧。
