Journal article
Smoking and Clinical Outcomes of Assisted Reproductive Technologies
Journal of women's health (Larchmont, N.Y. 2002), Vol.28(3), pp.314-322
03/01/2019
DOI: 10.1089/jwh.2018.7293
PMCID: PMC6420368
PMID: 30615563
Abstract
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 nonsmokers 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.
Details
- Title: Subtitle
- Smoking and Clinical Outcomes of Assisted Reproductive Technologies
- Creators
- Karilynn Rockhill - National Center for Chronic Disease Prevention and Health PromotionVan T. Tong - National Center for Chronic Disease Prevention and Health PromotionSheree L. Boulet - National Center for Chronic Disease Prevention and Health PromotionYujia Zhang - National Center for Chronic Disease Prevention and Health PromotionDenise J. Jamieson - National Center for Chronic Disease Prevention and Health PromotionDmitry M. Kissin - Centers for Disease Control and Prevention
- Resource Type
- Journal article
- Publication Details
- Journal of women's health (Larchmont, N.Y. 2002), Vol.28(3), pp.314-322
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/jwh.2018.7293
- PMID
- 30615563
- PMCID
- PMC6420368
- ISSN
- 1540-9996
- eISSN
- 1931-843X
- Number of pages
- 9
- Grant note
- CDC; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA U.S. Department of Energy; United States Department of Energy (DOE)
- Language
- English
- Date published
- 03/01/2019
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446431002771
Metrics
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