Abstract
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.
Highlights
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity
Questions pertaining to asthma and hay fever were requested by one of the authors (PCT) to be included in the 1995 National Survey of Family Growth (NSFG) to explore the relationship of allergic phenotype to fertility/fecundity
The 1995 NSFG sample was drawn from a larger sample of households previously interviewed for the 1993 National Health Interview Survey (NHIS)
Summary
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. Prior studies addressed fertility in women with asthma, these studies conceptualized fertility from different perspectives, analyzing live birth rates[13], currently defined as fecundity[12] or analyzing time to pregnancy >1 year[14], currently defined as infertility[12]. While both of these approaches provide important information, they do not address the process leading from pregnancy to pregnancy loss and are not comparable to the current analysis. As a prior study www.nature.com/scientificreports indicated that the numbers of previous pregnancies increase the risk of pregnancy losses[16], the current study analyzes the contributions of asthma and hay fever to the predictors of pregnancy loss controlling for the number of previous pregnancies
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