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Background Antepartum haemorrhage of unknown origin ( APHUO) is associated with preterm birth and perinatal mortality. Aim To determine whether smoking beyond the first trimester of pregnancy was an independent risk factor for APHUO. Methods Rates of APHUO were compared between non-smokers and smokers, and non-smokers and ceased smokers. Participants were healthy nulliparous women recruited to the Screening for Pregnancy Endpoints ( SCOPE) prospective cohort study in New Zealand, Australia, Ireland and United Kingdom. Logistic regression was used to compare adjusted odds ratio, 95% confidence intervals ( OR, 95% CI) of APHUO between continued smokers and non-smokers, adjusting for possible confounders. Results Of the 3513 participants, 77.9% ( n = 2737) were non-smokers, 10.6% ( n = 371) ceased in the first trimester and 11.5% ( n = 405) continued smoking beyond the first trimester. APHUO rates were higher in smokers than non-smokers (7.4%, n = 30 vs 4.5%, n = 122; P = 0.01), but there was no difference between ceased smokers and non-smokers (4.3%, n = 16 vs 4.5%, n = 122; P = 0.90). Smoking was no longer significantly associated with APHUO after adjustment for confounders (adjusted OR = 1.28, 95% CI 0.76-2.14), but vaginal bleeding in early pregnancy (adjusted OR = 2.98, 95% CI 2.12-4.18) and overweight/obesity (adjusted OR = 1.43, 95% CI 1.02-1.99) were independent risk factors. First trimester folic acid use was associated with a reduced risk (adjusted OR = 0.44, 95% CI 0.25-0.77). Conclusion Smoking is not an independent risk factor for APHUO after adjustment for confounders, but other risk and protective factors have been identified. [ABSTRACT FROM AUTHOR]

Many couples do not complete IVF treatment. There is little published data regarding this issue and also what changes might lead to better compliance rates. To investigate what proportion of patients discontinue IVF prematurely, why they stop treatment, and what factors are important for them to restart. Survey of 1310 patients undergoing IVF treatment over a 3-year period at a single IVF provider. Information was collection on demographics and the outcomes of treatment. For those who discontinued treatment two further questions were completed: reasons why treatment was discontinued (primary outcome measure) and factors required to reactivate fertility treatment (secondary outcome measure). 40.2% response rate. 15.0% of patients discontinued IVF prematurely; 77.0% had a live birth or were currently pregnant. Those who discontinued treatment were more likely to be older and have a trade qualification. Of those who discontinued treatment; failing to become pregnant, cost, and stress were identified as factors. Less expensive treatment and a guaranteed baby were important factors for patients to restart treatment. Numerous comments were made regarding having readily available counselling services and continuity of care. Reasons for stopping treatment are multifactorial. Our data set is limited by a low response rate. Further research is needed to into this issue, including differences between private and public cessation rates are barriers to completion of treatment. The majority of patients having IVF achieve either a live birth or fall pregnant through IVF. Service may be improved by decreasing cost, optimising outcomes and increasing availability of counselling services. [ABSTRACT FROM AUTHOR]