Westreich, D;
Cates, J;
Cohen, M;
Weber, KM;
Seidman, D;
Cropsey, K;
Wright, R;
... Adimora, AA; + view all
(2017)
Smoking, HIV, and risk of pregnancy loss.
AIDS
, 31
(4)
pp. 553-560.
10.1097/QAD.0000000000001342.
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Abstract
OBJECTIVE: Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. DESIGN: We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. METHODS: We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. RESULTS: Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9-27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0-19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. CONCLUSION: Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant.
| Type: | Article |
|---|---|
| Title: | Smoking, HIV, and risk of pregnancy loss |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000001342 |
| Publisher version: | http://doi.org/10.1097/QAD.0000000000001342 |
| Language: | English |
| Additional information: | Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
| Keywords: | Abortion, Spontaneous, Adult, Female, HIV Infections, Humans, Pregnancy, Pregnancy Complications, Infectious, Prospective Studies, Risk Assessment, Smoking, United States |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10043154 |
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