title: Association of in utero exposure to maternal smoking with reduced semen quality and testis size in adulthood: a cross-sectional study of 1,770 young men from the general population in five European countries.
abstract: Between 1996 and 1999, the authors invited all young men from five European countries who were undergoing compulsory medical examination for possible military service to participate in a study on male reproductive health. The participation rate was 19% in two cities in Denmark (n = 889), 17% in Oslo, Norway (n = 221), 13% in Turku, Finland (n = 313), 14% in Kaunas, Lithuania (n = 157), and 19% in Tartu, Estonia (n = 190). Each man provided a semen sample, was examined by a physician, and, in collaboration with his mother, completed a questionnaire about general and reproductive health, current smoking habits, and exposure to smoking in utero. After adjustment for confounding factors, men exposed to smoking in utero had a reduction in sperm concentration of 20.1% (95% confidence interval (CI): 6.8, 33.5) and a reduction in total sperm count of 24.5% (95% CI: 9.5, 39.5) in comparison with unexposed men. Percentages of motile and morphologically normal sperm cells were 1.85 (95% CI: 0.46, 3.23) and 0.64 (95% CI: -0.02, 1.30) percentage points lower, respectively, among men exposed in utero, and exposed men had a 1.15-ml (95% CI: 0.66, 1.64) smaller testis size. The associations were present when data from the study centers were analyzed separately (though not in Lithuania, where only 1% of mothers smoked during pregnancy), although the strength of the association varied. Maternal smoking may have long-term implications for the reproductive health of the offspring. This is another good reason to advise pregnant women to avoid smoking.
authors.affiliation: Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark. tkjensen@health.sdu.dk
authors.forename: Tina Kold
authors.initials: TK
authors.lastname: Jensen
authors.forename: Niels
authors.initials: N
authors.lastname: Jørgensen
authors.forename: Margus
authors.initials: M
authors.lastname: Punab
authors.forename: Trine B
authors.initials: TB
authors.lastname: Haugen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Suominen
authors.forename: Birute
authors.initials: B
authors.lastname: Zilaitiene
authors.forename: Antero
authors.initials: A
authors.lastname: Horte
authors.forename: Anne-Grethe
authors.initials: AG
authors.lastname: Andersen
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Carlsen
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Magnus
authors.forename: Valentinas
authors.initials: V
authors.lastname: Matulevicius
authors.forename: Ingrid
authors.initials: I
authors.lastname: Nermoen
authors.forename: Matti
authors.initials: M
authors.lastname: Vierula
authors.forename: Niels
authors.initials: N
authors.lastname: Keiding
authors.forename: Jorma
authors.initials: J
authors.lastname: Toppari
authors.forename: Niels E
authors.initials: NE
authors.lastname: Skakkebaek
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008889:Military Personnel; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012661:Semen / Q000502:physiology*; D012907:Smoking / Q000009:adverse effects*; D013076:Sperm Count; D011795:Surveys and Questionnaires; D013737:Testis / Q000473:pathology