title: Associations between adult and childhood secondhand smoke exposures and fecundity and fetal loss among women who visited a cancer hospital.
abstract: BACKGROUND
  A large percentage of the population continues to be exposed to secondhand smoke (SHS). Although studies have consistently linked active smoking to various pregnancy outcomes, results from the few studies examining SHS exposure and pregnancy difficulties have been inconsistent.
  
  
  METHODS
  Approximately 4800 women who presented to Roswell Park Cancer Institute between 1982 and 1998 and reported being pregnant at least once were queried about their childhood and adult exposures to SHS using a standardised questionnaire. Women were asked to report on selected prenatal pregnancy outcomes (fetal loss and difficulty becoming pregnant).
  
  
  RESULTS
  Approximately 11.3% of women reported difficulty becoming pregnant, while 32% reported a fetal loss or 12.4% reported multiple fetal losses. 40% reported any prenatal pregnancy difficulty (fetal loss and/or difficulty becoming pregnant). SHS exposures from their parents were associated with difficulty becoming pregnant (OR = 1.27, 95% CI 1.03 to 1.56) and lasting >1 year (OR = 1.34, 95% CI 1.12 to 1.60). Exposure to SHS in both at home during childhood and at the time of survey completion was also associated with fetal loss (OR = 1.39, 95% CI 1.17 to 1.66) and multiple fetal losses (OR = 1.62, 95% CI 1.25 to 2.11). Increasing current daily hours of SHS exposure as an adult was related to the occurrence of both multiple fetal loss and reduced fecundity (p(trend) < 0.05).
  
  
  CONCLUSIONS
  Reports of exposures to SHS during childhood and as an adult were associated with increased odds for prenatal pregnancy difficulties. These findings underscore the public health perspective that all people, especially women in their reproductive years, should be fully protected from tobacco smoke.
authors.affiliation: Department of Radiation Oncology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA. luke_peppone@urmc.rochester.edu
authors.forename: L J
authors.initials: LJ
authors.lastname: Peppone
authors.forename: K M
authors.initials: KM
authors.lastname: Piazza
authors.forename: M C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: G R
authors.initials: GR
authors.lastname: Morrow
authors.forename: K M
authors.initials: KM
authors.lastname: Mustian
authors.forename: O G
authors.initials: OG
authors.lastname: Palesh
authors.forename: A
authors.initials: A
authors.lastname: Hyland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology*; D018811:Maternal Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D012959:Socioeconomic Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution