Prepregnancy handling of antineoplastic drugs and risk of miscarriage in female nurses.

Journal Article (Journal Article)

PURPOSE: To examine the association betweenantineoplastic drug (AD) handling and risk of miscarriage. METHODS: Nurses' Health Study-3 participants self-reported AD administration and engineering controls (ECs) and personal protective equipment (PPE) use at baseline. We estimated the hazard ratio (HR) of miscarriage in relation to baseline AD handling using multivariable Cox proportional regression. RESULTS: Overall, 2440 nurses reported 3327 pregnancies, with 550 (17%) ended in miscarriages. Twelve percent of nurses self-reported currently handling AD and 28% previously handling AD. Compared with nurses who never handled AD, nurses who handled AD at baseline had an adjusted HR of miscarriage of 1.26 (95% confidence interval [CI], 0.97-1.64). This association was stronger after 12-weeks gestation (HR=2.39 [95% CI, 1.13-5.07]). Nurses who did not always use gloves had HR of 1.51 (95% CI, 0.91-2.51) compared with 1.19 (95% CI, 0.89-1.60) for those always using gloves; nurses who did not always use gowns had HR of 1.32 (95% CI, 0.95-1.83) compared with 1.19 (95% CI, 0.81-1.75) for nurses always using gowns. CONCLUSIONS: We observed a suggestive association between AD handling and miscarriage, particularly among nurses who did not consistently use PPE and EC with stronger associations for second trimester losses.

Full Text

Duke Authors

Cited Authors

  • Nassan, FL; Chavarro, JE; Johnson, CY; Boiano, JM; Rocheleau, CM; Rich-Edwards, JW; Lawson, CC

Published Date

  • January 2021

Published In

Volume / Issue

  • 53 /

Start / End Page

  • 95 - 102.e2

PubMed ID

  • 32920100

Pubmed Central ID

  • PMC7736108

Electronic International Standard Serial Number (EISSN)

  • 1873-2585

Digital Object Identifier (DOI)

  • 10.1016/j.annepidem.2020.09.003


  • eng

Conference Location

  • United States