Abstract：
Smoking during pregnancy is associated with negative reproductive outcome. Less is known about the impact of smoking or previous smoking in women with recurrent pregnancy loss (RPL) which this study aimed to investigate. We included all women <42 years (n=2829) referred to a RPL unit at Copenhagen University Hospital between January 2000 and December 2021 in the cohort with follow-up until June 2022. Patients were categorized as \'smokers at time of referral\', \'never-smokers\' or \'former smokers\'. The main outcomes were pregnancy history prior to referral, prospective pregnancy rate, live birth rate, rates of ectopic pregnancy, and stillbirth. At referral, smokers (n=373) were on average 2.0 years younger (P<0.001) and had experienced significantly more pregnancy losses (P<0.001), and stillbirths (P=0.01) compared to never-smokers (n=2100). Former smokers had a higher risk of stillbirth prior to referral compared to never-smokers but no differences in pregnancy rate or other outcomes. Prospective pregnancy rates were lower for smokers compared with never-smokers (71.8% vs. 77.5%, P=0.02). Live birth rate was 58.0% for the 243 women who smoked at referral compared to 61.4% for the 1488 never-smokers (P=0.32). Stillbirth and ectopic pregnancies were significantly more common for smokers (2.8% vs. 0.4%, P=0.01; 6.0% vs. 2.0%, P<0.008). Women with RPL who smoked at referral were referred younger with a higher number of previous pregnancy losses and stillbirths compared with never-smokers. Fewer smokers achieved a pregnancy after referral but those who did had a similar live birth rate compared to never-smokers, although stillbirths and ectopic pregnancies were more common.
摘要：
怀孕期间吸烟与阴性生殖结果有关。关于吸烟或先前吸烟对复发性妊娠丢失（RPL）女性的影响知之甚少，这项研究旨在调查。我们纳入了2000年1月至2021年12月期间所有42岁以下的女性（n=2829），这些女性转诊到哥本哈根大学医院的RPL病房，随访至2022年6月。患者在转诊时被归类为“吸烟者”，\'从不吸烟者\'或\'前吸烟者\'。主要结局是转诊前的妊娠史，预期怀孕率，活产率,异位妊娠率，和死产。在转诊时，吸烟者（n=373）平均年轻2.0岁（P<0.001），并且经历了更多的妊娠损失（P<0.001），和死产（P=0.01）与从不吸烟者（n=2100）相比。与从未吸烟者相比，前吸烟者在转诊前的死产风险更高，但在妊娠率或其他结局方面没有差异。与从不吸烟者相比，吸烟者的预期怀孕率更低(71.8%vs.77.5%,P=0.02)。转诊时吸烟的243名妇女的活产率为58.0％，而不吸烟的1488名妇女的活产率为61.4％（P=0.32）。待产和异位妊娠在吸烟者中更为常见(2.8%vs.0.4%,P=0.01；6.0%vs.2.0%,P<0.008)。与从不吸烟者相比，转诊时吸烟的RPL妇女转诊得更年轻，先前的妊娠损失和死胎数量更高。转诊后成功怀孕的吸烟者较少，但与不吸烟者相比，活产率相似。尽管死产和异位妊娠更为常见。
