Archives of Gynecology and Obstetrics

, Volume 283, Issue 4, pp 729–734 | Cite as

Association between tobacco use in pregnancy and placenta-associated syndromes: a population-based study

  • Muktar H. Aliyu
  • O’Neil Lynch
  • Ronee E. Wilson
  • Amina P. Alio
  • Sibylle Kristensen
  • Phillip J. Marty
  • Valerie E. Whiteman
  • Hamisu M. SalihuEmail author
Materno-fetal Medicine



Cigarette smoking is an established risk factor for adverse perinatal outcomes. The purpose of this study is to examine the association between maternal smoking in pregnancy and the occurrence of placental-associated syndromes (PAS).


We analyzed data from a population-based retrospective cohort of singleton deliveries that occurred in the state of Missouri from 1989 through 2005 (N = 1,224,133). The main outcome was PAS, a composite outcome defined as the occurrence of placental abruption, placenta previa, preeclampsia, small for gestational age, preterm or stillbirth. We used logistic regression models to generate adjusted odd ratios and their 95 percent confidence intervals. Non-smoking gravidas served as the referent category.


The overall prevalence of prenatal smoking was 19.6%. Cigarette smoking in pregnancy was associated with the composite outcome of placental syndromes (odds ratio, 95% confidence interval = 1.59, 1.57–1.60). This association showed a dose–response relationship, with the risk of PAS increasing with increased quantity of cigarettes smoked. Similar results were observed between smoking in pregnancy and independent risks for abruption, previa, SGA, stillbirth, and preterm delivery.


Maternal smoking in pregnancy is a risk factor for the development of placenta-associated syndrome. Smoking cessation interventions in pregnancy should continue to be encouraged in all maternity care settings.


Maternal smoking Placenta-associated syndrome Singletons Population-based study 


Conflict of interest statement

We declare that we have no conflict of interest.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Muktar H. Aliyu
    • 1
  • O’Neil Lynch
    • 2
  • Ronee E. Wilson
    • 3
  • Amina P. Alio
    • 4
  • Sibylle Kristensen
    • 5
  • Phillip J. Marty
    • 3
  • Valerie E. Whiteman
    • 6
  • Hamisu M. Salihu
    • 3
    Email author
  1. 1.Department of Preventive Medicine, Institute for Global HealthVanderbilt UniversityNashvilleUSA
  2. 2.Department of MathematicsMinnesota State UniversityMoorheadUSA
  3. 3.Center for Research and Evaluation, Lawton and Rhea Chiles Center for Healthy Mothers and BabiesUniversity of South FloridaTampaUSA
  4. 4.Department of Family and Community HealthUniversity of South FloridaTampaUSA
  5. 5.Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamUSA
  6. 6.Division of Maternal-Fetal-Medicine, Department of Obstetrics and GynecologyUniversity of South FloridaTampaUSA

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