Abstract
Objective: To estimate pregnancy loss incidence in a contemporary cohort of couples whose lifestyles were measured during sensitive windows of reproduction to identify factors associated with pregnancy loss for the continual refinement of preconception guidance. Design: Prospective cohort with preconception enrollment. Setting: Sixteen counties in Michigan and Texas. Patient(s): Three hundred forty-four couples with a singleton pregnancy followed daily through 7 postconception weeks of gestation. Intervention(s): None. Couples daily recorded use of cigarettes, caffeinated and alcoholic beverages, and multivitamins. Women used fertility monitors for ovulation detection and digital pregnancy tests. Pregnancy loss was denoted by conversion to a negative pregnancy test, onset of menses, or clinical confirmation depending upon gestation. Using proportional hazards regression and accounting for right censoring, we estimated adjusted hazard ratios and 95% confidence intervals (aHR, 95% CI) for couples' lifestyles (cigarette smoking, alcoholic and caffeinated drinks, multivitamins) during three sensitive windows: preconception, early pregnancy, and periconception. Main Outcome Measure(s): Incidence and risk factors for pregnancy loss. Result(s): Ninety-eight of 344 (28%) women with a singleton pregnancy experienced an observed pregnancy loss. In the preconception window, loss was associated with female age ≥35 years (1.96, 1.13-3.38) accounting for couples' ages, women's and men's consumption of >2 daily caffeinated beverages (1.74, 1.07-2.81; and 1.73, 1.10-2.72, respectively), and women's vitamin adherence (0.45, 0.25-0.80). The findings were similar for lifestyle during the early pregnancy and periconception windows. Conclusion(s): Couples' preconception lifestyle factors were associated with pregnancy loss, although women's multivitamin adherence dramatically reduced risk. The findings support continual refinement and implementation of preconception guidance.
| Original language | English (US) |
|---|---|
| Journal | Fertility and Sterility |
| DOIs | |
| State | Accepted/In press - Oct 26 2015 |
| Externally published | Yes |
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Keywords
- Caffeine
- Lifestyle
- Miscarriage
- Multivitamins
- Pregnancy loss
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Reproductive Medicine
Cite this
Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception : The LIFE Study. / Buck Louis, Germaine M.; Sapra, Katherine J.; Schisterman, Enrique F.; Lynch, Courtney D.; Maisog, José M.; Grantz, Katherine L.; Sundaram, Rajeshwari.
In: Fertility and Sterility, 26.10.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception
T2 - The LIFE Study
AU - Buck Louis, Germaine M.
AU - Sapra, Katherine J.
AU - Schisterman, Enrique F.
AU - Lynch, Courtney D.
AU - Maisog, José M.
AU - Grantz, Katherine L.
AU - Sundaram, Rajeshwari
PY - 2015/10/26
Y1 - 2015/10/26
N2 - Objective: To estimate pregnancy loss incidence in a contemporary cohort of couples whose lifestyles were measured during sensitive windows of reproduction to identify factors associated with pregnancy loss for the continual refinement of preconception guidance. Design: Prospective cohort with preconception enrollment. Setting: Sixteen counties in Michigan and Texas. Patient(s): Three hundred forty-four couples with a singleton pregnancy followed daily through 7 postconception weeks of gestation. Intervention(s): None. Couples daily recorded use of cigarettes, caffeinated and alcoholic beverages, and multivitamins. Women used fertility monitors for ovulation detection and digital pregnancy tests. Pregnancy loss was denoted by conversion to a negative pregnancy test, onset of menses, or clinical confirmation depending upon gestation. Using proportional hazards regression and accounting for right censoring, we estimated adjusted hazard ratios and 95% confidence intervals (aHR, 95% CI) for couples' lifestyles (cigarette smoking, alcoholic and caffeinated drinks, multivitamins) during three sensitive windows: preconception, early pregnancy, and periconception. Main Outcome Measure(s): Incidence and risk factors for pregnancy loss. Result(s): Ninety-eight of 344 (28%) women with a singleton pregnancy experienced an observed pregnancy loss. In the preconception window, loss was associated with female age ≥35 years (1.96, 1.13-3.38) accounting for couples' ages, women's and men's consumption of >2 daily caffeinated beverages (1.74, 1.07-2.81; and 1.73, 1.10-2.72, respectively), and women's vitamin adherence (0.45, 0.25-0.80). The findings were similar for lifestyle during the early pregnancy and periconception windows. Conclusion(s): Couples' preconception lifestyle factors were associated with pregnancy loss, although women's multivitamin adherence dramatically reduced risk. The findings support continual refinement and implementation of preconception guidance.
AB - Objective: To estimate pregnancy loss incidence in a contemporary cohort of couples whose lifestyles were measured during sensitive windows of reproduction to identify factors associated with pregnancy loss for the continual refinement of preconception guidance. Design: Prospective cohort with preconception enrollment. Setting: Sixteen counties in Michigan and Texas. Patient(s): Three hundred forty-four couples with a singleton pregnancy followed daily through 7 postconception weeks of gestation. Intervention(s): None. Couples daily recorded use of cigarettes, caffeinated and alcoholic beverages, and multivitamins. Women used fertility monitors for ovulation detection and digital pregnancy tests. Pregnancy loss was denoted by conversion to a negative pregnancy test, onset of menses, or clinical confirmation depending upon gestation. Using proportional hazards regression and accounting for right censoring, we estimated adjusted hazard ratios and 95% confidence intervals (aHR, 95% CI) for couples' lifestyles (cigarette smoking, alcoholic and caffeinated drinks, multivitamins) during three sensitive windows: preconception, early pregnancy, and periconception. Main Outcome Measure(s): Incidence and risk factors for pregnancy loss. Result(s): Ninety-eight of 344 (28%) women with a singleton pregnancy experienced an observed pregnancy loss. In the preconception window, loss was associated with female age ≥35 years (1.96, 1.13-3.38) accounting for couples' ages, women's and men's consumption of >2 daily caffeinated beverages (1.74, 1.07-2.81; and 1.73, 1.10-2.72, respectively), and women's vitamin adherence (0.45, 0.25-0.80). The findings were similar for lifestyle during the early pregnancy and periconception windows. Conclusion(s): Couples' preconception lifestyle factors were associated with pregnancy loss, although women's multivitamin adherence dramatically reduced risk. The findings support continual refinement and implementation of preconception guidance.
KW - Caffeine
KW - Lifestyle
KW - Miscarriage
KW - Multivitamins
KW - Pregnancy loss
UR - http://www.scopus.com/inward/record.url?scp=84961894433&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961894433&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2016.03.009
DO - 10.1016/j.fertnstert.2016.03.009
M3 - Article
C2 - 27016456
AN - SCOPUS:84961894433
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
ER -