Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception: The LIFE Study

Incidence of pregnancy loss was 28%. Risk of loss was 74% higher among couples consuming >2 daily caffeinated beverages, and 55% lower among women taking daily multivitamins.

Like Comment

Authors

Germaine M. Buck Louis, Ph.D., M.S., Katherine J. Sapra, M.Phil., M.P.H., Enrique F. Schisterman, Ph.D., M.A., Courtney D. Lynch, Ph.D., M.P.H., José M. Maisog, M.D., M.S., Katherine L. Grantz, M.D., M.S., Rajeshwari Sundaram, Ph.D., M.S.

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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(16)300...

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

No comments yet.