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Grand Rounds

Meta-Analysis Results: Does Paternal Smoking Increase the Risk for Pregnancy Loss?

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BACKGROUND AND PURPOSE:

  • du Fossé et al. (F&S Reviews, 2021) assessed the association between paternal lifestyle factors in the preconception period and the risk for pregnancy loss

METHODS:

  • Systematic reviews and meta-analysis
  • Study inclusion criteria
    • Studies that addressed the relationship between paternal exposure status in the preconception period and pregnancy loss
    • Excluded:  Studies limited to exposure status during pregnancy | Studies that only focused on pregnancy outcomes after artificial reproductive technology
  • Study design
    • Paternal lifestyle factors examined
      • Smoking
      • Alcohol consumption
      • BMI
    • Preconception period in men: Typically considered timeframe of approximately 10 weeks before conception in keeping with spermatogenic cycle | Authors of this meta-analysis did not use strict threshold
    • Meta-analysis using a random-effects model was performed if sufficient data were available
  • Primary outcome
    • Risk of pregnancy loss

RESULTS:

  • 11 studies | Study size ranged up to 5,770,691 pregnancies
    • Case-control: 6
    • Prospective cohort studies: 4
    • Retrospective cohort study: 1
  • Meta-analysis (8 studies): Paternal smoking of ≥10 cigarettes per day in the preconception period was associated with an increased risk of pregnancy loss after adjustment for maternal smoking status
    • 1 to 10 cigarettes per day: 1.01 (95% CI, 0.97 to 1.06)
    • 11 to 19 cigarettes per day: 1.12 (95% CI, 1.08 to 1.16)
    • ≥20 cigarettes per day: 1.23 (95% CI, 1.17 to 1.29)
  • No clear association was found between paternal alcohol consumption and pregnancy loss (5 studies)
  • There were no studies identified that evaluated the association between paternal BMI and pregnancy loss

CONCLUSION:

  • Paternal smoking of ≥10 cigarettes per day in the preconception period was associated with increased risk for pregnancy loss
  • Paternal smoking has implications for recurrent pregnancy loss
  • The authors state

The male contribution to adverse pregnancy outcome has been underevaluated for a long time

Here, we show that paternal smoking in the preconception period is associated with an increased risk of pregnancy loss in a dose-dependent manner, irrespective of maternal smoking habits

Learn More – Primary Sources:

Paternal smoking is associated with an increased risk of pregnancy loss in a dose-dependent manner: a systematic review and meta-analysis

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Does Smoking During Pregnancy Increase Risk of Bone Fractures in Offspring?
Could Smoking During Pregnancy Increase Risk for ADHD in Offspring?
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