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解析关联:环境烟草烟雾暴露与美国妇女(18-50 岁)不孕的关系。

Unraveling the link: environmental tobacco smoke exposure and its impact on infertility among American women (18-50 years).

机构信息

The Second People's Hospital of Jingdezhen, Jingdezhen, China.

出版信息

Front Public Health. 2024 Mar 8;12:1358290. doi: 10.3389/fpubh.2024.1358290. eCollection 2024.

Abstract

PURPOSE

The detrimental effects of environmental tobacco smoke (ETS) on women's reproductive health have been widely recognized. However, the detailed association between exposure to environmental tobacco smoke and the incidence of infertility remains under-explored. This investigation focuses on exploring this potential connection.

METHODS

For this analysis, we extracted data from the US National Health and Nutrition Examination Survey (NHANES) database, covering the years 2013 to 2018, focusing on individuals with recorded serum cotinine levels and infertility information. ETS exposure and fertility status were analyzed as independent and dependent variables, respectively. We applied weighted multivariate logistic regression method to evaluate the impact of ETS on infertility, including subgroup analyses for more detailed insights.

RESULTS

The study encompassed 3,343 participants. Logistic regression analysis revealed a notable positive correlation between ETS exposure and infertility, with an odds ratio (OR) of 1.64 (95% Confidence Interval [CI]: 1.14-2.36). We observed a non-linear relationship between ETS exposure and infertility risk. Notably, infertility risk increased by 64% in serum cotinine levels above 0.136 compared to that in serum cotinine levels below 0.011. Further, subgroup analysis and interaction tests showed consistent results across different segments, underscoring the robustness of the ETS-infertility link.

CONCLUSION

Our findings suggest that environmental tobacco smoke exposure may be a contributing factor to infertility. These results reinforce the recommendation for women in their reproductive years to avoid ETS exposure, especially when planning for pregnancy.

摘要

目的

环境烟草烟雾(ETS)对女性生殖健康的有害影响已得到广泛认可。然而,暴露于环境烟草烟雾与不孕发生率之间的详细关联仍未得到充分探索。本研究旨在探讨这种潜在联系。

方法

本分析从美国国家健康和营养调查(NHANES)数据库中提取了 2013 年至 2018 年的数据,重点关注有记录的血清可替宁水平和不孕信息的个体。将 ETS 暴露和生育状况分别作为独立和因变量进行分析。我们应用加权多变量逻辑回归方法评估 ETS 对不孕的影响,包括更详细的亚组分析。

结果

本研究共纳入 3343 名参与者。逻辑回归分析显示,ETS 暴露与不孕之间存在显著正相关,比值比(OR)为 1.64(95%置信区间 [CI]:1.14-2.36)。我们观察到 ETS 暴露与不孕风险之间存在非线性关系。值得注意的是,与血清可替宁水平低于 0.011 相比,血清可替宁水平高于 0.136 时,不孕风险增加了 64%。此外,亚组分析和交互检验表明,不同亚组的结果一致,这突显了 ETS-不孕关联的稳健性。

结论

我们的研究结果表明,环境烟草烟雾暴露可能是不孕的一个促成因素。这些结果强化了建议生育年龄的女性避免 ETS 暴露的建议,尤其是在计划怀孕时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad8/10957781/bae5a15afdf6/fpubh-12-1358290-g001.jpg

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