Time-to-Pregnancy Associated With Couples' Use of Tobacco Products
Time-to-Pregnancy Associated With Couples' Use of Tobacco Products
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DOI：
10.1093/ntr/ntw132
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发表时间：
2016-11-01
影响因子：
4.7
通讯作者：
Louis, Germaine M. Buck
中科院分区：
文献类型：
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作者：
Sapra, Katherine J.;Barr, Dana B.;Louis, Germaine M. Buck
以前的研究表明，女性吸烟增加了怀孕时间（TTP），这是一种依赖于夫妇的生殖结果，而与男性吸烟的关系则更加模糊。此外，尽管在美国无烟烟草的使用略有增加，但之前没有研究评估无烟烟草使用者中的TTP。在密歇根州和得克萨斯州的16个县使用基于人口的抽样，对501对夫妇停止避孕怀孕进行了跟踪，直到妊娠试验呈阳性或尝试12个月。参与者接受了采访，一生和目前的香烟，雪茄，嚼/鼻烟（无烟）的使用，并提供血液样本的重金属和可替宁的定量。估计生育率比值比（FO）和95%置信区间（95% CI），并根据人口统计学/生活方式进行调整。11%的女性和15%的男性吸烟。在男性中，14%的人抽雪茄，9%的人使用鼻烟，2%的人使用咀嚼。与从不吸烟者相比，男性（FOR：0.41，95% CI：0.24，0.68）和女性（FOR：0.53，95% CI：0.33，0.85）吸烟者个体与TTP较长相关;男性吸烟者在一起建模时仍具有显著性（FOR：0.46，95% CI：0.27，0.79）。吸烟者的镉水平高于无烟烟草和从不吸烟者;调整镉减弱了T-TTP相关性，特别是在女性中。无烟烟草使用者的TTP短于吸烟者（FOR：2.86，95%CI：1.47，5.57），与从不吸烟者相比，无烟烟草使用者的TTP没有改变，但与吸烟者相比，TTP短。我们观察到男性和女性吸烟者的TTP较长;镉可能是部分原因。伴侣双方的孕前吸烟导致TTP较长，突出了伴侣双方的生活方式在健康生殖中的重要性，并强调了基于夫妇的孕前指导的必要性。男性的贡献是一个新的发现。较高的镉水平可能部分导致吸烟者的TTP较长，特别是女性。虽然我们没有观察到更长的TTP无烟烟草使用者与从不吸烟者相比，我们观察到较短的TTP与吸烟者相比，在一个小样本。需要进一步的工作来更彻底地描述无烟烟草使用和TTP之间的关系以及烟草使用对生殖影响的可能机制。
Previous studies suggest female smoking increases time-to-pregnancy (TTP), a couple-dependent reproductive outcome, while associations with male smoking are more ambiguous. Furthermore, despite small increases in smokeless tobacco use in the United States, no prior study has evaluated TTP among smokeless tobacco users.Using population-based sampling in 16 counties in Michigan and Texas, 501 couples discontinuing contraception to become pregnant were followed until positive pregnancy test or 12 months of trying. Participants were interviewed on lifetime and current cigarette, cigar, and chew/snuff (smokeless) use and provided blood samples for quantification of heavy metals and cotinine. Fecundability odds ratios (FORs) and 95% confidence intervals (95% CIs) were estimated, adjusted for demographics/lifestyle. FORs less than 1 reflect longer TTP.Eleven percentage of females and 15% of males smoked cigarettes. Among men, 14% smoked cigars, 9% used snuff, and 2% used chew. Compared with never tobacco users, male (FOR: 0.41, 95% CI: 0.24, 0.68) and female (FOR: 0.53, 95% CI: 0.33, 0.85) smoking were individually associated with longer TTP; males' smoking remained significant (FOR: 0.46, 95% CI: 0.27, 0.79) when modeling partners together. Cadmium levels were higher in smokers than smokeless tobacco and never users; adjusting for cadmium attenuated the cigarette-TTP association, particularly among women. TTP was shorter among smokeless tobacco users relative to smokers (FOR: 2.86, 95% CI: 1.47, 5.57).Compared with never users, smokeless tobacco did not alter TTP in our cohort; however, TTP was shorter compared with smokers. We observed longer TTP in male and female smokers; cadmium may partially contribute.Both partners' preconception smoking contributed to longer TTP, highlighting the importance of both partners' lifestyles in healthy reproduction and underscores the need for couple-based preconception guidance. The male's contribution is a new finding. Higher cadmium levels may partially contribute to longer TTP in smokers, particularly among females. Though we do not observe longer TTP among a small sample of smokeless tobacco users compared with never tobacco users, we observe shorter TTP compared with smokers. Further work is needed to more thoroughly delineate the relationship between smokeless tobacco use and TTP and possible mechanisms of tobacco use's effects on reproduction.