Paternal smoking and spontaneous abortion: a population-based retrospective cohort study among non-smoking women aged 20-49 years in rural China

J Epidemiol Community Health. 2018 Sep;72(9):783-789. doi: 10.1136/jech-2017-210311. Epub 2018 Jun 11.


Background: To comprehensively evaluate the association of paternal smoking and spontaneous abortion.

Methods: We conducted a population-based retrospective cohort study among 5 770 691 non-smoking rural Chinese women, along with their husbands, participating in the National Free Pre-Pregnancy Checkups Project, regarding outcome events that occurred in 2010-2016. The main outcome was spontaneous abortion (SA). Multivariable logistic regression was used to estimate OR and 95% CI, and restricted cubic spline was used to estimate the non-linear relationship.

Results: The multivariable-adjusted OR of exposure to paternal smoking for SA was 1.17 (95% CI 1.16 to 1.19), compared with women without exposure to paternal smoking; and corresponding OR of exposure to preconception paternal smoking for SA was 1.11 (95% CI 1.08 to 1.14), compared with women without exposure to preconception paternal smoking. The ORs of preconception paternal smoking also increased with increases in paternal smoking (pnonlinear<0.05, almost linearly shaped) and preconception paternal smoking (pnonlinear>0.05). In addition, periconception paternal smoking cessation was associated with an 18% (15%-22%) lower risk of SA.

Conclusion: Paternal smoking was associated with SA. The importance of tobacco control, specifically pertaining to paternal smoking, should be emphasised during preconception and pregnancy counselling.

Keywords: abortion; paternal smoking; preconception; smoking cessation; spontaneous; tobacco smoking pollution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Spontaneous / chemically induced*
  • Adult
  • China
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Parents*
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Rural Population
  • Smoking / adverse effects*
  • Young Adult