吸烟、饮酒和咖啡消费与妊娠丢失：一项孟德尔随机化研究。
Smoking, alcohol and coffee consumption and pregnancy loss: a Mendelian randomization investigation.
机构信息
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
出版信息
Fertil Steril. 2021 Oct;116(4):1061-1067. doi: 10.1016/j.fertnstert.2021.05.103. Epub 2021 Jun 27.
OBJECTIVE
To determine the associations of smoking and alcohol and coffee consumption with pregnancy loss.
DESIGN
Mendelian randomization study.
SETTING
The UK Biobank study and FinnGen consortium.
PATIENTS
A total of 60,565 cases with pregnancy loss and 130,687 noncases from UK Biobank and 3,312 cases with pregnancy loss and 64,578 noncases from FinnGen.
INTERVENTION(S): None.
MAINS OUTCOME MEASURE
Pregnancy loss.
RESULT(S): Genetic predisposition to smoking initiation was associated with an increased risk of pregnancy loss in both UK Biobank and FinnGen. The combined odds ratio (OR) was 1.31 (95% confidence interval [CI], 1.25-1.37) for one standard deviation increase in the prevalence of smoking initiation. There were no significant associations of genetically predicted consumption of alcohol (OR, 1.09; 95% CI, 0.93-1.27) or coffee (OR, 0.96; 95% CI, 0.87-1.06) with pregnancy loss.
CONCLUSION(S): This study on the basis of genetic data suggests the causal potential of the association of smoking but not moderate alcohol and coffee consumption with pregnancy loss.
目的
确定吸烟、饮酒和咖啡摄入与妊娠丢失的关联。
设计
孟德尔随机化研究。
设置
英国生物库研究和芬兰遗传研究联合会。
患者
英国生物库中共有 60565 例妊娠丢失病例和 130687 例非病例，以及芬兰遗传中 3312 例妊娠丢失病例和 64578 例非病例。
干预措施
无。
主要结局测量
妊娠丢失。
结果
遗传易感性与吸烟起始相关，在英国生物库和芬兰遗传中均与妊娠丢失风险增加相关。在英国生物库中，一个标准差的起始吸烟流行率增加对应的合并优势比（OR）为 1.31（95%置信区间[CI]，1.25-1.37）。遗传预测的饮酒（OR，1.09；95% CI，0.93-1.27）或咖啡（OR，0.96；95% CI，0.87-1.06）摄入与妊娠丢失之间没有显著关联。
结论
基于遗传数据的这项研究表明，吸烟与妊娠丢失之间的关联存在因果关系，但中度饮酒和咖啡摄入与妊娠丢失之间不存在因果关系。
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