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Paternal smoking and spontaneous abortion: a population-based retrospective cohort study among non-smoking women aged 20–49 years in rural China
  1. Long Wang1,2,3,
  2. Ying Yang1,4,
  3. Fangchao Liu5,
  4. Aimin Yang3,6,
  5. Qin Xu1,2,
  6. Qiaomei Wang1,7,
  7. Haiping Shen7,
  8. Yiping Zhang7,
  9. Donghai Yan7,
  10. Zuoqi Peng1,4,
  11. Yuan He1,4,
  12. Yuanyuan Wang1,4,
  13. Jihong Xu1,4,
  14. Jun Zhao1,4,
  15. Hongguang Zhang1,4,
  16. Ya Zhang1,4,
  17. Qiaoyun Dai1,4,
  18. Xu Ma1,2,4
  1. 1 National Research Institute for Family Planning, Beijing, China
  2. 2 Graduate School of Peking Union Medical College, Beijing, China
  3. 3 School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, China
  4. 4 National Human Genetic Resources Center, Beijing, China
  5. 5 Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  6. 6 Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
  7. 7 Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
  1. Correspondence to Dr Ying Yang, National Research Institute for Family Planning, National Human Genetic Resources Center, Beijing 100081, China; angela-yy65{at}hotmail.com and Dr Xu Ma, National Research Institute for Family Planning, National Human Genetic Resources Center, Graduate School of Peking Union Medical College, Beijing 100081, China; nfpcc_ma{at}163.com

Abstract

Background To comprehensively evaluate the association of paternal smoking and spontaneous abortion.

Methods We conducted a population-based retrospective cohort study among 5 770 691 non-smoking rural Chinese women, along with their husbands, participating in the National Free Pre-Pregnancy Checkups Project, regarding outcome events that occurred in 2010–2016. The main outcome was spontaneous abortion (SA). Multivariable logistic regression was used to estimate OR and 95% CI, and restricted cubic spline was used to estimate the non-linear relationship.

Results The multivariable-adjusted OR of exposure to paternal smoking for SA was 1.17 (95% CI 1.16 to 1.19), compared with women without exposure to paternal smoking; and corresponding OR of exposure to preconception paternal smoking for SA was 1.11 (95% CI 1.08 to 1.14), compared with women without exposure to preconception paternal smoking. The ORs of preconception paternal smoking also increased with increases in paternal smoking (pnonlinear<0.05, almost linearly shaped) and preconception paternal smoking (pnonlinear>0.05). In addition, periconception paternal smoking cessation was associated with an 18% (15%–22%) lower risk of SA.

Conclusion Paternal smoking was associated with SA. The importance of tobacco control, specifically pertaining to paternal smoking, should be emphasised during preconception and pregnancy counselling.

  • tobacco smoking pollution
  • smoking cessation
  • paternal smoking
  • preconception
  • abortion
  • spontaneous

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Footnotes

  • YY and XM are co-corresponding authors.

  • Contributors YY and XM conceived the study, provided overall guidance and revised the manuscript. XM, LW and YY have full access to the data in the study and take responsibility for the data integrity and the accuracy of data analysis. LW, YY and FL designed and supervised the study. QW, HS and DY led the data collection. LW searched the literature, analysed the data, interpreted the results and drafted the manuscript. YZ, DY, ZP, YH, YW, JX, JZ, HZ, YZ and QD collected the data. FL, YY, AY and QX revised the manuscript. All authors contributed to the critical revisions of the manuscript.

  • Funding This study was supported by the National Key Research and Development Program of China (grant no. 2016YFC1000300, grant no. 2016YFC1000307), the National Natural Science Foundation of China (grant no. 81402757) and the operation expenses for basic scientific research of the central authorities (no. 2016GJZ10).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The National Health and Family Planning Commission.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement NFPCP data contained sensitive data and cannot be shared via public deposition because of information governance restrictions in place to protect individuals’ confidentiality. Access to data for external researchers (not affiliated with the National Research Institute for Family Planning) requires researchers to be physically based in the institute. Access to data is available only once approval has been obtained through the individual constituent entities controlling access to the data.

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