Honorato-Rzeszewicz Talita, Hoek Annemieke, Haadsma Maaike L, Groen Henk
University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, the Netherlands.
Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.
Prev Med Rep. 2025 Sep 1;58:103228. doi: 10.1016/j.pmedr.2025.103228. eCollection 2025 Oct.
Animal studies have shown meiotic errors in follicles after exposure to cigarette smoke in-utero. Epidemiological studies investigating effects of in-utero smoke exposure on fetal loss in humans show inconclusive results and did not control for extraneous smoke exposure. We aimed to investigate the association between cigarette smoke exposure in-utero and risk of fetal loss, independent of active or second-hand smoking.
We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort ( = 15,445, April 1991-December 1992, Bristol, England). From obstetric history data and questionnaires completed by the participants we assessed previous fetal loss and whether the participant's mother smoked when pregnant with the participant, smoking habits and second-hand smoking. Fetal loss was defined as miscarriage up to 28 weeks of gestation or stillbirth. We performed logistic regression adjusting for confounding and stratifying for smoke exposure.
In 7033 women in-utero smoke exposure and fetal loss status were known; 2012 were exposed to smoke in-utero; 687 of them (34.1 %) ever had a fetal loss. Ever smokers with exposure in-utero ( = 1182) had higher odds of ever having a fetal loss than ever smokers unexposed in-utero ( = 2354, adjusted OR: 1.26; 95 % CI: 1.08, 1.47, -value < 0.01 for interaction between ever smoking and in-utero exposure). Evaluation of less common combinations of in-utero and extraneous smoke exposure was hampered by small numbers.
In-utero smoke exposure is associated with increased odds of fetal loss when occurring in combination with active smoking of the participants, compounding the odds of fetal loss.
动物研究表明，子宫内暴露于香烟烟雾后，卵泡会出现减数分裂错误。调查子宫内烟雾暴露对人类胎儿丢失影响的流行病学研究结果尚无定论，且未对外部烟雾暴露进行控制。我们旨在研究子宫内香烟烟雾暴露与胎儿丢失风险之间的关联，而不考虑主动吸烟或二手烟情况。
我们使用了阿冯父母与儿童纵向研究（ALSPAC）队列的数据（n = 15445，1991年4月 - 1992年12月，英国布里斯托尔）。根据参与者填写的产科病史数据和问卷，我们评估了既往胎儿丢失情况，以及参与者的母亲在怀该参与者时是否吸烟、吸烟习惯和二手烟情况。胎儿丢失定义为妊娠28周前的流产或死产。我们进行了逻辑回归分析，对混杂因素进行调整，并按烟雾暴露情况进行分层。
在7033名已知子宫内烟雾暴露和胎儿丢失状况的女性中，2012名在子宫内暴露于烟雾；其中687名（34.1%）曾有过胎儿丢失。子宫内暴露的既往吸烟者（n = 1182）比未在子宫内暴露的既往吸烟者（n = 2354）有更高的胎儿丢失几率（调整后的比值比：1.26；95%置信区间：1.08，1.47；既往吸烟与子宫内暴露之间的交互作用p值<0.01）。子宫内和外部烟雾暴露的较少见组合的评估因样本量小而受阻。
当子宫内烟雾暴露与参与者的主动吸烟同时发生时，会增加胎儿丢失的几率，使胎儿丢失的几率更高。
