Preconception Vaping, Alcohol Use Had “No Meaningful Association” with Spontaneous Abortion in New Study

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Preconception alcohol consumption and nicotine vaping were not significantly associated with increased risk of spontaneous abortion, according to new research.

Data supporting the results were presented at the American Urological Association (AUA) 2024 Annual Meeting in San Antonio, TX, May 3-6, and suggested that neither alcohol use or vaping by either or both partners prior to conception are linked to spontaneous abortion risk. The collective findings are based on 2 analyses participants in the North American-based Pregnancy Study Online (PRESTO) preconception cohort trial and expand what study authors say are limited data on the impact of either behavior on reproductive outcomes.

PRESTO is a cohort analysis of couples planning pregnancy from 2013 – 2023. All PRESTO female participants and their male partners completed baseline questionnaires during the preconception period, which collected information on demographics and lifestyle characteristics, including alcohol consumption and nicotine vaping and other tobacco use, according to the 2 study abstracts. Women then completed bimonthly follow-up questionnaires for 12 months regarding status of pregnancy.

Alcohol use and spontaneous abortion

Investigators analyzed data from 9414 female participants, as well as 2613 couples with complete data from both partners on alcohol consumption. They categorized alcohol consumption as none; light (1 – 7 drinks per week); moderate (8 – 14/week); and heavy (≥14/week).

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Men in the cohort had a mean age of 32 years and women 30 years; a majority (86%) of participants identified as White. Looking at the full cohort, researchers reported that 60% of female participants reported light drinking, 11% reported moderate drinking, and 3% reported heavy drinking. Among participants in the couple-based cohort, half (49%) of men reported light drinking, 20% moderate, and 12% heavy drinking.

Findings

The primary outcome, spontaneous abortion, occurred in approximately 1 in every 5 pregnancies in both the couple-based cohort (22%) and the full cohort (21%).

In analysis of the couples cohort, the researchers found no statistically significant association between preconception male partner drinking of any level vs no alcohol consumption and spontaneous abortion:

• Light drinking (HR, 0.98; 95% CI, 0.77 – 1.25)
• Moderate drinking (HR, 0.95; 95% CI, 0.70 – 1.28)
• Heavy drinking (HR, 0.94; 95% CI, 0.67 – 1.31)

When they evaluated the full cohort investigators reported no significant risk of spontaneous abortion among women with moderate (HR, 0.97; 95% CI, 0.83 – 1.13) and heavy (HR, 0.86; 95% CI, 0.64 – 1.15) alcohol consumption vs among women who did not drink. In contrast, they found a slightly lower risk of spontaneous abortion among women who reported light drinking during preconception vs those who reported no use of alcohol (HR, 0.88; 95% CI, 0.79 – 0.98). Looking again at the couple-based cohort, stratification of the group by female partner age revealed “no meaningful effect modification” on the alcohol consumption-spontaneous abortion association.

“Preconception alcohol consumption by either partner was not meaningfully associated with incidence of spontaneous abortion,” authors concluded in the study abstract.

Vaping, other tobacco use and spontaneous abortion

For their analysis of the potential impact of nicotine vaping on incident spontaneous abortion, researchers had complete questionnaire data on use of tobacco for 6136 women and 1668 couples. Mean ages for men and women paralleled those for the alcohol analysis, ie, 32 years and 30 years, respectively, as did the proportion of participants identifying as White (85%).

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At baseline, current vaping was reported by 13% of women in the full cohort, current cigarette smoking by 3%, and former smoking by 11%, according to the study abstract. Among couples, 19% of men reported current vaping.

Findings

Once again, findings mirrored those of the alcohol investigation. The researchers reported 22% of pregnancies ending in spontaneous abortion in the full cohort and 24% doing so in the couples cohort. They found no significant association in the couples-based cohort between current male vaping and incident spontaneous abortion (HR, 0.95; 95% CI, 0.72 – 1.26) and described a “modest but imprecise positive association” between female vaping and the negative outcome (HR, 1.31; 95% CI, 0.61 – 2.79).

In a full-cohort comparison of risk associated with no tobacco use by women vs types of tobacco use, investigators reported no significant associations for female vaping only, female smoking only, or female vaping plus smoking. After stratifying the women by current, former, or never smoking status, they further reported no meaningful association with incident spontaneous abortion.

“Nicotine vaping in either partner during the preconception period was not appreciably associated with spontaneous abortion incidence,” investigators concluded. “There was also little evidence that cigarette smoking modified the association between vaping and spontaneous abortion incidence."

References

1. Scott M, Zhang CA, Eisenberg M, Wise L. A preconception cohort study of alcohol use and incidence of spontaneous abortion. J Urol. Published May 1, 2024. doi:10.1097/01.JU.0001008832.14212.d6.12
2. Scott M, Zhang CA, Wang T, Harlow AF, et al. A preconception cohort study of nicotine vaping and incidence of spontaneous abortion. J Urol. Published May 1, 2024. doi:10.1097/01.JU.0001008832.14212.d6.11