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The Association Between Second-hand Smoke Exposure and Psychiatric Distress Among Naturally Pregnant Women and Pregnant Women After Assisted Reproductive Technology Treatment: a Birth Cohort Study

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Abstract

Second-hand smoke (SHS) has been shown to be associated with psychiatric distress in pregnant women spontaneously conceived (SC), but this has never been investigated in pregnant women with assisted reproductive technology (ART) treatment. This study aimed to investigate and compare the associations of SHS with psychiatric distress among SC and ART pregnant women. Participants (1467 SC and 857 ART women) were from the sub-study of Chinese National Birth Cohort (CNBC) in Anhui Province. SHS was assessed by the self-reported questionnaire. The symptoms of depression, anxiety, stress, and poor sleep quality were assessed using CES-D, SAS, CPSS, and PSQI questionnaire. Multivariable linear regression was used to determine the association between SHS and psychiatric distress in each trimester. In SC women, SHS (yes or no) was associated with depression and anxiety symptoms in the 3rd trimester (β = 0.90, 95% CI 0.07–1.73 for depression and β = 1.21, 95% CI 0.39–2.04 for anxiety) and stress symptom and poor sleep quality in both the 2nd and 3rd trimesters (β = 0.85, 95% CI 0.20–1.49 in the 2nd trimester and β = 0.69, 95% CI 0.07–1.32 in the 3rd trimester for stress, and β = 1.32, 95% CI 0.68–1.96 in the 2nd trimester and β = 1.38, 95% CI 0.64–2.11 in the 3rd trimester for poor sleep quality). By contrast, in ART women, SHS was associated with depression and stress symptoms in the 1st trimester (β = 1.97, 95% CI 0.59–3.35 for depression and β = 1.18, 95% CI 0.24–2.12 for stress) and poor sleep quality throughout the pregnancy (β = 0.64, 95% CI 0.22–1.06 in the 1st trimester, β = 0.77, 95% CI 0.35–1.18 in the 2nd trimester, and β = 0.99, 95% CI 0.50–1.48 in the 3rd trimester, respectively). Our findings indicate a universal and detrimental effect of SHS on psychiatric health among both SC and ART pregnant women. However, the SHS impact may be more substantial at the early stage of pregnancy for ART women and at later stages for SC women. This implies the importance of reducing SHS exposure during pregnancy and the necessary to be aware of the difference in the effect of SHS on psychiatric distress between SC and ART women.

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References

  1. Class QA, Lichtenstein P, Långström N, D'Onofrio BM. Timing of prenatal maternal exposure to severe life events and adverse pregnancy outcomes: a population study of 2.6 million pregnancies. Psychosom Med. 2011;73:234–41.

    Article  Google Scholar 

  2. Zhu P, Tao F, Hao J, Sun Y, Jiang X. Prenatal life events stress: implications for preterm birth and infant birthweight. Am J Obstet Gynecol. 2010;203:34. e1–8.

    Article  Google Scholar 

  3. Monk C, Lugo-Candelas C, Trumpff C. Prenatal developmental origins of future psychopathology: mechanisms and pathways. Annu Rev Clin Psychol. 2019;15:317–44.

    Article  Google Scholar 

  4. World Health Organization, Maternal mental health, Mental health. http://www.who.int/mental_health/maternal-child/maternal_mental_health/en/. Accessed 10 May 2021.

  5. Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22:1506–12.

    Article  Google Scholar 

  6. Sominsky L, Hodgson DM, McLaughlin EA, Smith R, Wall HM, Spencer SJ. Linking stress and infertility: a novel role for ghrelin. Endocr Rev. 2017;38:432–67.

    Article  Google Scholar 

  7. Yang G. Marketing ‘less harmful, low-tar’ cigarettes is a key strategy of the industry to counter tobacco control in China. Tob Control. 2014;23:167–72.

    Article  Google Scholar 

  8. World Health Organization. WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. 2013b. http://www.who.int/tobacco/publications/pregnancy/guidelinestobaccosmokeexposure/en/. Accessed 10 May 2021.

  9. Mineur YS, Picciotto MR. Nicotine receptors and depression: revisiting and revising the cholinergic hypothesis. Trends Pharmacol Sci. 2010;31:580–6.

    Article  CAS  Google Scholar 

  10. Varescon I, Leignel S, Gerard C, Aubourg F, Detilleux M. Self-esteem, psychological distress, and coping styles in pregnant smokers and non-smokers. Psychol Rep. 2013;113:935–47.

    Article  Google Scholar 

  11. Wang X. Rating scales for mental health (revised and enlarged edition). Beijing: Chin Ment Health J; 1999. p. 318–20.

    Google Scholar 

  12. Luo Y, Gong B, Meng R, Cao X, Tang S, Fang H, et al. Validation and application of the Chinese version of the Perceived Stress Questionnaire (C-PSQ) in nursing students. PeerJ. 2018;6:e4503.

    Article  Google Scholar 

  13. Zhang N, Zhang Y, Ma M, Zhang T, Qiu P. Reliability and construct validity of the center for epidemiological studies depression scale in a rural women population. Sichuan Da Xue Xue Bao Yi Xue Ban. 2014;45:827–30 841.

    PubMed  Google Scholar 

  14. Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.

    Article  Google Scholar 

  15. de Jong M, Woodward M, Peters SA. Diabetes, glycated hemoglobin, and the risk of myocardial infarction in women and men: a prospective cohort study of the UK Biobank. Diabetes Care. 2020;43:2050–9.

    Article  Google Scholar 

  16. Suzuki D, Wariki WMV, Suto M, Yamaji N, Takemoto Y, Rahman MM, et al. Association of secondhand smoke and depressive symptoms in nonsmoking pregnant women: a systematic review and meta-analysis. J Affect Disord. 2019;245:918–27.

    Article  Google Scholar 

  17. Farr SL, Schieve LA, Jamieson DJ. Pregnancy loss among pregnancies conceived through assisted reproductive technology, United States, 1999–2002. Am J Epidemiol. 2007;165:1380–8.

    Article  Google Scholar 

  18. Lang J, Zhang B, Meng Y, Du Y, Cui L, Li W. First trimester depression and/or anxiety disorders increase the risk of low birthweight in IVF offspring: a prospective cohort study. Reprod BioMed Online. 2019;39:947–54.

    Article  Google Scholar 

  19. Ohida T, Kaneita Y, Osaki Y, Harano S, Tanihata T, Takemura S, et al. Is passive smoking associated with sleep disturbance among pregnant women? Sleep. 2007;30:1155–61.

    Article  Google Scholar 

  20. Cai S, Feng Y, Wang Y, Wu S, Zhan Y, Ma S, et al. Factors associated with sleep quality during first and second trimester in Chinese pregnant woman. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41:711–5.

    CAS  PubMed  Google Scholar 

  21. Arbuckle TE, Liang CL, Fisher M, Caron NJ, Fraser WD, and the MSG. Exposure to tobacco smoke and validation of smoking status during pregnancy in the MIREC study. J Expo Sci Environ Epidemiol. 2018;28:461–9.

    Article  CAS  Google Scholar 

  22. Tourangeau R, Yan T, Sun H, Hyland A, Stanton CA. Population Assessment of Tobacco and Health (PATH) reliability and validity study: selected reliability and validity estimates. Tob Control. 2019;28:663–8.

    Article  Google Scholar 

  23. Ma X, Wang Y, Hu H, Tao XG, Zhang Y, Shi H. The impact of resilience on prenatal anxiety and depression among pregnant women in Shanghai. J Affect Disord. 2019;250:57–64.

    Article  Google Scholar 

  24. Costantine MM, Smith K, Thom EA, Casey BM, Peaceman AM, Varner MW, et al. Effect of thyroxine therapy on depressive symptoms among women with subclinical hypothyroidism. Obstet Gynecol. 2020;135:812–20.

    Article  CAS  Google Scholar 

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Funding

To date this work has been supported by National Key Research and Development Program of China (2016YFC1000204-3 and 2016YFC1000204-2) and National Natural Science Foundation of China (NSFC-82000399).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  2. NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  3. Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  4. Anhui Province Key Laboratory of Reproductive Health and Genetics, Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  5. Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  6. Anhui Provincial Institute of Translational Medicine, Hefei, Anhui, China

    Xiaoqing Peng, Chunmei Liang, Zhimin Lu, Xiaofeng Xu, Cong Ma & Yunxia Cao

  7. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China

    Guoqi Cai

  8. The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, China

    Guoqi Cai

  9. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China

    Kun Huang, Hong Gan & Fangbiao Tao

  10. MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, China

    Kun Huang, Hong Gan & Fangbiao Tao

  11. NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China

    Kun Huang, Hong Gan & Fangbiao Tao

  12. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, Anhui, China

    Kun Huang, Hong Gan & Fangbiao Tao

Authors
  1. Xiaoqing Peng
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  2. Guoqi Cai
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  3. Chunmei Liang
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  4. Zhimin Lu
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  5. Kun Huang
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  6. Hong Gan
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  7. Xiaofeng Xu
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  8. Cong Ma
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  9. Fangbiao Tao
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  10. Yunxia Cao
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Contributions

XP contributed to data collection, analysis and interpretation of data and drafted manuscript; GC, CL, and KH contributed to analysis and interpretation of data and critical revision of manuscript; ZL, HG, XX, and CM contributed to data collection and quality control. FT and YC: project conception and study design, interpretation of data, and critical revision of manuscript.

Corresponding authors

Correspondence to Fangbiao Tao or Yunxia Cao.

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Peng, X., Cai, G., Liang, C. et al. The Association Between Second-hand Smoke Exposure and Psychiatric Distress Among Naturally Pregnant Women and Pregnant Women After Assisted Reproductive Technology Treatment: a Birth Cohort Study. Reprod. Sci. 28, 2878–2886 (2021). https://doi.org/10.1007/s43032-021-00602-6

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  • DOI: https://doi.org/10.1007/s43032-021-00602-6

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