Exposure to Tobacco Smoke in Utero and the Risk of Stillbirth and Death in the First Year of Life (original) (raw)
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Prenatal tobacco use and risk of stillbirth: A case-control and bidirectional case-crossover study
Nicotine & Tobacco Research, 2008
We sought to estimate the association between prenatal smoking and stillbirth in a longitudinal cohort using two study designs: a case-control study and a bidirectional case-crossover study. The analysis was conducted using the Missouri maternally linked cohort dataset from 1978 through 1997. In the case-control study, each mother contributed only one birth to the analysis. For the bidirectional crossover design, analysis was restricted to women who gave birth to at least one stillbirth, and the controls comprised all live births before and after the stillbirth. The independent association between prenatal smoking and stillbirth was computed using nonconditional (case-control design) and conditional (bidirectional case-crossover design) logistic regression. Prenatal smoking decreased from 29.7% in 1978 to 21.2% by 1997 (p,.001). The absolute risk of stillbirth was greater among smokers (7.7/1000) than nonsmokers (5.3/1000), p,.001. In the case-control design, the risk of stillbirth was 34% greater among smokers than nonsmokers (OR51.34, 95% CI 1.26-1.43). For each 10-unit increase in the number of cigarettes consumed per day prenatally, the likelihood of stillbirth rose by about 14% (p,.001). In the bidirectional casecrossover design, the association between stillbirth and smoking during pregnancy was confirmed, although the magnitude of the relationship was smaller (OR51.20, 95% CI 1.03-1.39). In conclusion, we found prenatal smoking to be a risk factor for stillbirth even after minimizing the influence of known and unknown sources of confounding as well as changes in temporal trend in prenatal smoking.
Smoking in early gestation or through pregnancy: A decision crucial to pregnancy outcome
Preventive Medicine, 2007
Objective. To assess maternal risk profile and pregnancy outcome of women who continued to smoke, reduced smoking to less than five cigarettes per day or did not smoke during pregnancy. Methods. We analyzed a population-based database of 26,414 singleton pregnancies from 1989 to 2001. Odds ratios (ORs) for adverse pregnancy outcomes were obtained from multiple logistic regression models. Results. The prevalence of smoking in early pregnancy was 25.7% and went down to 12.7% at 20 weeks of pregnancy. Women who smoked were more often young, primiparous or unmarried, used alcohol and more often had prior pregnancy terminations than women who did not smoke. Women who reduced smoking were mostly primiparous, and they also quit using alcohol. Continuing to smoke was associated with elevated risks of small-for-gestational-age infants (SGA) (OR 2.11), preterm birth (OR 1.15) and perinatal death (OR 1.15). SGA was avoided by reducing smoking, but not prematurity (OR 1.18) or elevated risk of perinatal death (OR 1.18). Conclusion. Smoking in early gestation and through pregnancy is associated with adverse pregnancy outcomes, and some of the harmful effects can be avoided by reducing smoking, although the behavioral risk profile of those who reduced smoking is closer to that of smokers than of non-smokers.
Maternal and child health journal, 2003
The objectives of the study were: 1) To determine the risk of infant mortality associated with prenatal cigarette smoking; 2) To assess whether the relationship, if existent, was dose-dependent; 3) To explore the morbidity pathway that explains the effect of tobacco smoke on infant mortality, and 4) to compute excess infant deaths attributable to maternal smoking in the United States. Retrospective cohort study on 3,004,616 singleton live births that occurred in 1997 in the United States using the US national linked birth/infant death data. Excess infant deaths due to maternal smoking were computed using the population-attributable risk (PAR). Overall, 13.2% of pregnant women who delivered live births in 1997 smoked during pregnancy. The rate of infant mortality was 40% higher in this group as compared to nonsmoking gravidas (P < 0.0001). This risk increased with the amount of cigarettes consumed prenatally in a dose-dependent fashion (p for trend < 0.0001). Small-for-gestatio...
Journal of Clinical and Translational Research, 2022
Background: Tobacco use is one of the most important causes of obstetric and perinatal pathologies. Its frequency during pregnancy is high and could be related to various socioeconomic and cultural characteristics of the mothers. Aim: The aim of this study is to determine the trend and prevalence of smoking in pregnant mothers in our area over the years and the socio-cultural or obstetric factors associated with smoking as well as the repercussions on the newborns related to its consumption. Methods: Retrospective study of 18,959 mothers of healthy newborns in the maternity ward of the regional hospital during the years 2002–2019. The variable under study was maternal smoking during pregnancy compared with various maternal, obstetric, and perinatal factors. Results: A mean percentage of 20.4% of the mothers smoked, with significantly decreasing percentages over the years. There was a significant association between smoking and mothers’ age, origin, level of education, the occurrence...
American journal of epidemiology, 2016
We conducted a systematic review and 3-part meta-analysis to characterize the relationship between smoking and perinatal death, defined as the combination of stillbirth and neonatal death. The PubMed database was searched (1956-August 31, 2011) with keywords, and manual reference searches of included articles and Surgeon Generals' reports were conducted. The full texts of 1,713 articles were reviewed, and 142 articles that examined the associations between active or passive smoking and perinatal death were included in the meta-analyses. Data were abstracted by 2 reviewers. Any active maternal smoking was associated with increased risks of stillbirth (summary relative risk (sRR) = 1.46, 95% confidence interval (CI): 1.38, 1.54 (n = 57 studies)), neonatal death (sRR = 1.22, 95% CI: 1.14, 1.30 (n = 28)), and perinatal death (sRR = 1.33, 95% CI: 1.25, 1.41 (n = 46)). The risks of stillbirth, neonatal death, and perinatal death increased with the amount smoked by the mother. Biases i...
Acta Obstetricia Et Gynecologica Scandinavica, 2010
Objective. To investigate pregnancy outcomes among women living with smokers. Design. Data were from a cohort study of 1,217 women recruited during 3-7th month of pregnancy and 96% followed-up after delivery. The main objective was to investigate effects of smokeless tobacco on pregnancy outcomes. Setting. Lower and middle-class neighborhoods in Mumbai, India. Community health volunteers who had good rapport with the local population collaborated with the study personnel to help locate and interact with potential participants. Population. Singleton births from non-tobacco users; n = 924/903/802 for stillbirth/gestational age/birthweight analysis. Non-smoking women who lived with smokers (28%) were categorized as 'exposed' to second hand smoke (SHS). Methods. House-to-house surveys with questionnaire administration and medical records abstraction by trained personnel at recruitment and follow-up. Outcome measures. Stillbirth (no evidence of life at birth after at least 20 weeks of gestation), low birthweight (£ 2,499 g) and preterm birth (£ 258 days of gestation). Results. Rates of low birthweight and preterm birth were not significantly different between exposed and non-exposed. Hazard ratio for stillbirth in SHS exposed women (n = 261) was 2.2 (95% confidence interval 1.1-4.4). Survival times differed significantly between exposed and non-exposed, p = 0.012. Exposed and non-exposed groups differed significantly by education, socioeconomic status, parity and access of antenatal care. After adjustment for these potential confounders in Cox proportional hazards models (gestational age in days as timescale), hazard ratios for stillbirth in the exposed group remained unchanged: 2.1 (1.1-4.3). Conclusions. Pregnant women living with smokers in their household have a significantly higher risk of stillbirth, independent of differences in socio-demographic characteristics and antenatal care.
The unborn smoker: association between smoking during pregnancy and adverse perinatal outcomes
Journal of perinatal medicine, 2014
Objective: To evaluate a possible dose-response relationship between active maternal smoking during pregnancy and adverse perinatal outcome. Design: Retrospective cohort study. Setting: Population-based in Montreal, Quebec, Canada. Population: Women who gave birth to a liveborn or stillborn infant during the period of January 2001 to December 2007. Methods: Active smokers of different daily cigarette consumption (n=1646) were identified through maternal self-reporting. The reference group comprised 19,292 non-smoking women who delivered during the same period. Main outcome measures: Birth weight, preterm delivery rate, fetal and neonatal mortality and morbidity, and congenital malformations. Results: Preterm delivery rate was significantly higher in the smoking group compared with controls (22.2% vs. 12.4%, P<0.05), as was intrauterine fetal demise (1.4% vs. 0.3%, P<0.05). Newborns of active smokers were more likely to weigh less (3150±759 g vs. 3377±604 g, P<0.05), suffer ...
Effects of tobacco use during pregnancy on infant and child health
Demiroglu Science University Florence Nightingale Journal of Medicine, 2020
This review discusses the tobacco-using habits, especially cigarette smoking, of parents while focusing on women, before, during, and after pregnancy and the effects on the mother, infant, child, and prenatal fetus as well as the diseases that may occur. Data from many studies and surveys have shown that tobacco use causes various complications. Exposure of the in-utero fetus to tobacco smoke either directly or passively prevents its healthy and sufficient development. These effects persist after birth ranging among hypertension to obesity, insufficient lung development, neurodevelopment, behavioral problems, and many other fields. Without a doubt, this situation also causes similar problems in the mother as it does in the child.
American Journal of Epidemiology, 1997
The purposes of this study were to examine the association between setf-reported environmental tobacco smoke (ETS) exposure during pregnancy and birth weight, prematurity, and small-for-gestational age infants and to determine whether these associations differ by maternal age. Data from the Pregnancy Nutrition Surveillance System from two states that collected data on both passive and active smoking for the penod 1989-1994 were analyzed. ETS exposure was defined as reported exposure to the cigarette smoke of a household member. Multiple logistic and linear regression analyses were used to evaluate the association between ETS and birth outcomes. The mean adjusted birth weight among infants of nonsmoking mothers age 30 years or older was 90 g less among infants exposed to ETS than among infants not exposed. No significant association was found among infants of younger nonsmoking mothers. Similarly, the nsks for low birth weight (adjusted odds ratio (OR) = 2.42, 95% confidence interval 1.51-3.87) and preterm delivery (adjusted OR = 1.88, 95% confidence interval 1.22-2 88) were elevated among older nonsmokers exposed to ETS, but not among younger nonsmokers exposed to ETS (adjusted OR = 0.97, 95% confidence interval 0.76-1.23; adjusted OR = 0.92, 95% confidence interval 0.76-1.13, for low birth weight and preterm delivery, respectively). These findings indicate that the association between ETS exposure and adverse pregnancy outcomes appears to be modified by maternal age. Am J Epidemiol 1997; 146:42-7. birth weight; environmental pollution, tobacco smoke; infant, premature; infant, small-for-gestational age; maternal age Studies have shown that smoking during pregnancy elevates the risk of delivering a low birth weight (LBW), preterm, or small-for-gestational age (SGA) infant and that this risk increases with increasing maternal age (1-5). The literature on the association between environmental tobacco smoke (ETS) and pregnancy outcome has shown that exposure to ETS also elevates the risk of adverse birth outcomes. Martin and Bracken (6) demonstrated that ETS exposure for at least 2 hours per day resulted in a mean birth weight reduction of 85 g and a twofold increased risk of LBW among the infants of nonsmokers. Since then, several other studies have demonstrated that infants