{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:00:04Z","timestamp":1788210004947,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["OLL 836701"],"award-info":[{"award-number":["OLL 836701"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["OLL 929557"],"award-info":[{"award-number":["OLL 929557"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["nos OLL\u2010837211"],"award-info":[{"award-number":["nos OLL\u2010837211"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>It is unclear whether tobacco in early pregnancy and alcohol use preceding pregnancy are associated with spontaneous abortion. The purpose was to investigate if use of tobacco and\/or alcohol is associated with spontaneous abortion among women attending antenatal care, and if age and body mass index (BMI) attenuate the risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A population\u2010based cohort study based on data from the Swedish Pregnancy Register. All pregnant women having had the first antenatal visit from January 2014 to July 2018 were included (<jats:italic>n<\/jats:italic>\u00a0=\u00a0525\u2009604). The register had information about smoking and use of snuff before and in early pregnancy, as well as data on alcohol habits before pregnancy, measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated questionnaire. Logistic regression analysis was used to estimate the association between lifestyle factors and spontaneous abortion, and multiple imputation was used to impute missing data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 34\u2009867 (6.6%) pregnancies ended in a spontaneous abortion after the first visit to maternal health care. At the first maternal healthcare visit, daily smoking was reported by 24\u2009214 (5.1%), and 6403 (1.2%) used snuff. For 19\u2009837 (4.2%) women, a high alcohol score was reported for the year preceding pregnancy. After adjusting for potential confounders and multiple imputation, use of tobacco was associated with spontaneous abortion; smoking 1\u20139 cigarettes\/day (adjusted odds ratio [aOR] 1.11, 95% confidence interval [CI] 1.04\u20131.18), smoking 10 or more cigarettes\/day (aOR 1.12, 95% CI 1.\u20131.26), and use of snuff (aOR 1.20, 95% CI 1.06\u20131.37). Higher AUDIT scores were not significantly associated with spontaneous abortion (AUDIT 6\u20139: aOR 1.03, 95% CI 0.97\u20131.10 and AUDIT 10 or more: aOR 1.07, 95% CI 0.94\u20131.22). Increasing maternal age showed the highest risk of spontaneous abortion from the age of 35, and BMI of 30\u2009kg\/m<jats:sup>2<\/jats:sup> or more increased the risk. There were interactions between different lifestyle factors associated with spontaneous abortion that could either increase or decrease the risk of spontaneous abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smoking and use of snuff were associated with an increased risk of spontaneous abortion. The AUDIT scores preceding pregnancy were not associated with an increased risk of spontaneous abortion, which contradicts the results from previous studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14470","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T09:28:11Z","timestamp":1665566891000},"page":"15-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The association of smoking, use of snuff, and preconception alcohol consumption with spontaneous abortion: A population\u2010based cohort study"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-4676","authenticated-orcid":false,"given":"Yvonne","family":"Skogsdal","sequence":"first","affiliation":[{"name":"Maternal Health Care Unit, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Karlsson","sequence":"additional","affiliation":[{"name":"University Health Care Research Center Faculty of Medicine and Health, \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Tyd\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Akademiska Sjukhuset  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehal","family":"Patil","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics, School of Medical Sciences \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2691-7525","authenticated-orcid":false,"given":"Helena","family":"Backman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmy025"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt334"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200410001669187"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.1.85"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12694"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2003.00244.x"},{"key":"e_1_2_8_8_1","unstructured":"Statistics on Pregnancies Deliveries and Newborn Infants 2018.2020.https:\/\/www.socialstyrelsen.se\/en\/search\u2010results\/?q=pregnancies&_t_dtq=true"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh259"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr189"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14124"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181661431"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1995.56.423"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00498.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-14-364"},{"key":"e_1_2_8_16_1","unstructured":"AUDIT The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care.2001.https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/67205\/WHO_MSD_MSB_01.6a.pdf?sequence=1&isAllowed=y"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600589677"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2021.100622"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-780"},{"key":"e_1_2_8_20_1","volume-title":"The Health Consequences of Smoking: A Report of the Surgeon General","author":"Office of the Surgeon General (US); 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