What is a significant risk factor for gestational trophoblastic disease?

A history of a molar pregnancy is a significant risk factor for gestational trophoblastic disease because prior occurrences of this condition increase the likelihood of its recurrence in subsequent pregnancies. Gestational trophoblastic disease encompasses a spectrum of abnormal trophoblastic tissue growth, with molar pregnancies being the most common form. Women who have experienced a molar pregnancy are at higher risk due to potential underlying genetic or environmental factors that contribute to abnormal trophoblastic proliferation.

The other options listed do not have as strong a correlation with the development of gestational trophoblastic disease. For instance, while factors like cigarette smoking, diethylstilbestrol exposure, and excessive alcohol consumption have established links to various reproductive health issues, they are not specifically identified as direct risk factors for gestational trophoblastic diseases in the literature. Thus, the direct link between a previous molar pregnancy and an increased risk of recurrence makes it the most relevant and significant risk factor in this context.