Cannabis use while trying to conceive: a prospective cohort study evaluating associations with fecundability, live birth and pregnancy loss.
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ABSTRACT:
SUBMITTER: Mumford SL
PROVIDER: S-EPMC8679412 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
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Cannabis use while trying to conceive: a prospective cohort study evaluating associations with fecundability, live birth and pregnancy loss.
Mumford S L SL Flannagan K S KS Radoc J G JG Sjaarda L A LA Zolton J R JR Metz T D TD Plowden T C TC Perkins N J NJ DeVilbiss E A EA Andriessen V C VC A C Purdue-Smithe PS Kim K K Yisahak S F SF Freeman J R JR Alkhalaf Z Z Silver R M RM Schisterman E F EF
Human reproduction (Oxford, England) 20210401 5
<h4>Study question</h4>Is cannabis use assessed via urinary metabolites and self-report during preconception associated with fecundability, live birth and pregnancy loss?<h4>Summary answer</h4>Preconception cannabis use was associated with reduced fecundability among women with a history of pregnancy loss attempting pregnancy despite an increased frequency of intercourse.<h4>What is known already</h4>Cannabis use continues to rise despite limited evidence of safety during critical windows of pre ...[more]
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Project description:ObjectiveTo assess the use of cervical mucus monitoring (CMM) in women trying to conceive and determine whether monitoring is associated with increased cycle-specific probability of conception (fecundability).DesignTime-to-pregnancy cohort study.SettingPopulation-based cohort.Patient(s)Three hundred thirty-one women trying to conceive, ages 30 to 44 years, without known infertility.Intervention(s)None.Main outcome measure(s)CMM prevalence and fecundability.Result(s)During the first cycle of the study, CMM was performed consistently (checked on >66% of pertinent cycle days) by 20 women (6%), inconsistently (34% to 66% of days) by 60 women (18%), infrequently (?33% of days) by 73 women (22%), and not performed by 178 women (54%). Cycles in which CMM was consistently performed were statistically significantly more likely to result in conception after adjusting for age, race, previous pregnancy, body mass index, intercourse frequency, and urinary luteinizing hormone (LH) monitoring. Fecundability also increased with increasing consistency of CMM.Conclusion(s)Among women trying to conceive, CMM is uncommon, but our study suggests that CMM-a free, self-directed method to determine the fertile window-is associated with increased fecundability independent of intercourse frequency or use of urinary LH monitoring.
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Project description:ContextWith the increase of obesity, it is imperative to understand the neuroendocrine mechanisms, including the neuroendocrine hormone leptin, by which obese or overweight women are at increased risk for subfertility and infertility.ObjectiveThe objective was to examine associations between preconception serum leptin concentrations, fecundability, pregnancy, and live birth.DesignSecondary analysis of a prospective cohort among women with prior pregnancy losses.SettingThe study was conducted at four US medical centers (2006 to 2012).InterventionNot available.Materials and methodsPreconception serum leptin concentrations were measured at baseline, and women were followed for up to six menstrual cycles, and throughout pregnancy if they conceived. Discrete Cox proportional hazard regression models were used to assess fecundability odds ratios (FORs) and log-binomial regression to estimate risk ratios (RRs) for pregnancy and live birth. Models were adjusted for age, physical activity, treatment arm, and adiposity, either by measured waist-to-hip ratio or body mass index (BMI).ResultsHigh leptin concentrations were associated with decreased fecundability (FOR 0.72, 95% CI 0.58, 0.90), reduced risk of pregnancy (RR 0.87, 95% CI 0.78, 0.96) and live birth (RR 0.76, 95% CI 0.65, 0.89) comparing the upper to the lower tertile. However, adjustment for BMI in lieu of waist-to-hip ratio nullified observed associations.ConclusionsIn women with a history of pregnancy loss, relations between higher preconception leptin and fecundability were attenuated after adjustment for BMI, although not after adjustment for other markers of adiposity. Leptin may serve as a complementary marker of adiposity for assessment of obesity and reproductive outcomes.
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Project description:BackgroundLittle is known about potential health effects of eating organic food in relation to reproduction.ObjectiveWe examined associations between organic food consumption and fecundability.MethodsData were derived from a preconception cohort study of Danish couples trying to conceive (SnartForaeldre.dk, SF). Participants completed a baseline questionnaire on socio-demographics, anthropometrics and lifestyle and a validated food-frequency questionnaire, which included questions on proportions of organic food consumed within six food groups. Participants were followed up with bimonthly questionnaires for up to 12 months or until pregnancy. Analyses were restricted to 2061 participants attempting pregnancy for ≤6 cycles at enrollment and 1303 with <3 cycles. Fecundability ratios (FRs) and 95% confidence intervals (CI) were estimated by proportional probabilities regression models adjusted for potential confounders including age, lifestyle and socioeconomic factors. Associations were examined for vegetables, fruits, cereals, dairy products, eggs and meat, separately, and for the overall pattern of organic food consumption (organic sum score).ResultsThe final analytic sample comprised 2069 participants. In the full cohort, organic food consumption was not meaningfully associated with fecundability. Among participants <3 cycles of pregnancy attempt at study entry (n = 1303), the FR was 1.11 (95% CI 0.93, 1.33) for the category 'less than half', for 'more than half' the FR was 1.17 (95% CI 0.99, 1.38) and for 'almost everything' the FR was 1.12 (95% CI 0.97, 1.28).ConclusionHigher consumption of organic foods was not meaningfully associated with fecundability, although slightly greater fecundability was seen among participants with <3 cycles of pregnancy attempt time.
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Project description:Fecundability, the probability of conception in a month or in a menstrual cycle, varies across and within age groups for both women and men. Fertility treatment has become common in a number of countries including Japan, but its impact on the age pattern of fecundability is unknown. By utilizing the previously collected data on time to pregnancy (TTP) of Japanese couples trying to conceive their first child, the present study aimed to estimate fecundability and sterility by women's age and to assess how the estimates may differ by including or excluding assisted conceptions. Duration between discontinuing contraception and conception (including both natural and assisted) resulted in a live birth was called TTP-all, and the duration ending with natural conception was called TTP-natural. TTP-natural was censored when a participant received fertility consultation or treatment. A zero-inflated beta distribution model was used to estimate a proportion of sterile (zero probability of conception) and a distribution of fecundability for each age group. Parameters of the distribution were estimated using the maximum likelihood method. When TTP-all and TTP-natural were used, the sterile proportion of the whole sample was, respectively, 2% and 14%, and the median (interquartile range) of fecundability was, respectively, 0.10 (0.04, 0.19) and 0.11 (0.05, 0.19). The median (interquartile range) of fecundability was 0.18 (0.10, 0.29) for women aged 24 years or younger and 0.05 (0.02, 0.13) for 35-39 years old when TTP-all was used, and the estimates were quite similar with those based on TTP-natural: it was 0.18 (0.10, 0.29) for women aged 24 years or younger and 0.06 (0.00, 0.15) for 35-39 years old. Exclusion of assisted conceptions resulted in larger proportions of sterility, but it had little impact on median or interquartile ranges of fecundability estimates. Fecundability is overall lower at higher ages, while interquartile ranges are overlapping, suggesting that inter-individual variability of fecundability within an age group is as large as the variability across age groups.
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Project description: Not available
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Project description:ObjectiveTo evaluate the associations between preconception sleep characteristics and shift work with fecundability and live birth.DesignSecondary analysis of the Effects of Aspirin in Gestation and Reproduction study, a preconception cohort.SettingFour US academic medical centers.Patient(s)Women aged 18-40 with a history of 1-2 pregnancy losses who were attempting to conceive again.Intervention(s)Not applicable.Main outcome measures(s)We evaluated baseline, self-reported sleep duration, sleep midpoint, social jetlag, and shift work among 1,228 women who were observed for ≤6 cycles of pregnancy attempts to ascertain fecundability. We ascertained live birth at the end of follow up via chart abstraction. We estimated fecundability odds ratios (FORs) using discrete, Cox proportional hazards models and risk ratios (RRs) for live birth using log-Poisson models.Result(s)Sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.81, 95% confidence interval [CI], 0.61; 1.08), later sleep midpoints (3rd tertile vs. 2nd tertile: FOR: 0.85; 95% CI, 0.69, 1.04) and social jetlag (continuous per hour; FOR: 0.93, 95% CI: 0.86, 1.00) were not associated with reduced fecundability. In sensitivity analyses, excluding shift workers, sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.62; 95% CI, 0.42; 0.93) was associated with low fecundability. Night shift work was not associated with fecundability (vs. non-night shift work FOR: 1.17, 95% CI, 0.96; 1.42). Preconception sleep was not associated with live birth.Conclusion(s)Overall, there does not appear to be a strong association between sleep characteristics, fecundability, and live birth. Although these findings may suggest weak and imprecise associations with some sleep characteristics, our findings should be evaluated in larger cohorts of women with extremes of sleep characteristics.Clinical trial registration numberClinicaltrials.gov NCT00467363.
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Project description:BackgroundOpioids are commonly prescribed to women of reproductive age, including after delivery and miscarriage. However, to our knowledge, opioid use has not been frequently studied in relation to the common reproductive complications of impaired fecundability and pregnancy. We examined the association of opioid use during the critical window of pregnancy establishment with fecundability and pregnancy loss.MethodsWe measured opioid use by urine screening and self-report at multiple time points during preconception and early pregnancy in a prospective cohort of women attempting conception (n=1228). The main outcomes included time to hCG-detected pregnancy and incidence of live birth and pregnancy loss. We estimated fecundability odds ratios (FOR) and risk ratios (RR) with 95% confidence intervals (CI) adjusting for sociodemographic characteristics, reproductive characteristics, and use of antidepressants, tobacco, alcohol, and marijuana.ResultsPrevalence of preconception opioid use was 18% (n=226 of 1228), and in early pregnancy was 5% (n=33 of 685). Opioid use while attempting pregnancy was associated with reduced fecundability (FOR: 0.71; 95% CI: 0.50, 1.0). Risk of pregnancy loss increased as opioid exposure was detected later in gestation, from the beginning of the cycle of conception (RR: 1.5; 95% CI 0.85, 2.6), to week 4 of pregnancy (RR: 2.1; 95% CI: 1.1, 4.1), and to week 4 and 8 of pregnancy (RR: 2.5; 95% CI: 1.3, 5.0).ConclusionsOur results are consistent with the hypothesis that opioid exposure while trying to conceive may be harmful, even among healthy, non-opioid-dependent women. Possible risks to fecundability and pregnancy viability are relevant to patients and providers when evaluating pain management approaches.ClinicalTrials.gov registration number: #NCT00467363.
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Project description:AimThe aim of this study was to investigate lifestyle habits and lifestyle adjustments among subfertile women trying to conceive.Materials and methodsWomen (n = 747) were recruited consecutively at their first visit to fertility clinics in mid-Sweden. Participants completed a questionnaire. Data were analyzed using logistic regression, t tests, and chi-square tests.ResultsThe response rate was 62% (n = 466). Mean duration of infertility was 1.9 years. During this time 13.2% used tobacco daily, 13.6% drank more than three cups of coffee per day, and 11.6% consumed more than two glasses of alcohol weekly. In this sample, 23.9% of the women were overweight (body mass index, BMI 25-29.9 kg/m(2)), and 12.5% were obese (BMI ≥30 kg/m(2)). Obese women exercised more and changed to healthy diets more frequently than normal-weight women (odds ratio 7.43; 95% confidence interval 3.7-14.9). Six out of ten women (n = 266) took folic acid when they started trying to conceive, but 11% stopped taking folic acid after some time. Taking folic acid was associated with a higher level of education (p < 0.001).ConclusionsAmong subfertile women, one-third were overweight or obese, and some had other lifestyle factors with known adverse effects on fertility such as use of tobacco. Overweight and obese women adjusted their habits but did not reduce their body mass index. Women of fertile age would benefit from preconception counseling, and the treatment of infertility should routinely offer interventions for lifestyle changes.
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Project description:BackgroundLittle is known about the predictors of sexual intercourse frequency (SIF) among couples trying to conceive despite the well-established link between SIF and fecundity.AimTo evaluate men's and women's demographic, occupational, and lifestyle predictors of SIF among couples.Methods469 Couples without a history of infertility participating in the Longitudinal Investigation of Fertility and the Environment Study (2005-2009) were followed up for ≤1 year while trying to conceive. At enrollment, both partners were interviewed about demographic, occupational, lifestyle, and psychological characteristics using standardized questionnaires. Multivariable generalized linear mixed models with Poisson distribution were used to estimate the adjusted percent difference in SIF across exposure categories.OutcomesSIF was recorded in daily journals and summarized as average SIF/mo.ResultsThe median (interquartile range) SIF during follow-up was 6 (4-9) acts/mo. For every year increase in age for women and men, SIF decreased by -0.8% (95% CI -2.5 to 1.0%) and -1.7% (95% CI -3.1 to -0.3%). Women with high school education or less and those of non-white race had 34.4% and 16.0% higher SIF, respectively. A similar trend was seen for men's education and race. Only couples where both partners (but not just 1 partner) worked rotating shifts had -39.1% (95% CI -61.0 to -5.0%) lower SIF compared to couples where neither partner worked rotating shifts. Men's (but not women's) exercise was associated with 13.2% (95% CI 1.7-26.0%) higher SIF. Diagnosis of a mood or anxiety disorder in men (but not women) was associated with a 26.0% (95% CI -42.7 to -4.4%) lower SIF. Household income, smoking status, body mass index, night work, alcohol intake, and psychosocial stress were not associated with SIF.Clinical translationEven among couples trying to conceive, there was substantial variation in SIF. Both partners' age, education, race, and rotating shift work as well as men's exercise and mental health play an important role in determining SIF.ConclusionsAs this was a secondary analysis of an existing study, we lacked information on many pertinent psychological and relationship quality variables and the hormonal status of participants, which could have affected SIF. The unique population-based couple design, however, captured both partners' demographics, occupational characteristics, and lifestyle behaviors in advance of their daily, prospective reporting of SIF, which was a major strength. Important predictors of SIF among couples attempting to conceive include men's exercise and mental health and both partners' age, education, race, and rotating shift work. Gaskins AJ, Sundaram R, Buck Louis GM, et al. Predictors of Sexual Intercourse Frequency Among Couples Trying to Conceive. J Sex Med 2018;15:519-528.
| S-EPMC5882561 | biostudies-literature