Association between tobacco use in pregnancy and placenta-associated syndromes: a population-based study
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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.
KeywordsMaternal smoking Placenta-associated syndrome Singletons Population-based study
Conflict of interest statement
We declare that we have no conflict of interest.
- 5.Jaffe R (2001) Development of early uteroplacental circulation. Early Preg 5:34–35Google Scholar
- 9.[No authors listed] (2002) Women and smoking: a report of the Surgeon General. Executive Summary. MMWR Recomm Rep 51:1–13Google Scholar
- 11.Cogswell ME, Weisberg P, Spong C (2003) Cigarette smoking, alcohol use and adverse pregnancy outcomes: implications for micronutrient supplementation. J Nutr 133:1722–1731Google Scholar
- 12.Martin J, Curtin S, Saulnier M, Mousavi J (2003) Development of the matched multiple birth file: 1995–1998 matched multiple birth dataset. NCHS CD-ROM series 21, no. 13a. National Center for Health Statistics, HyattsvilleGoogle Scholar
- 14.Aliyu MH, Luke S, Kristensen S, Alio A, Salihu HM. Joint effect of obesity and teenage pregnancy on the risk of preeclampsia: a population-based study. J Adolesc Health (in press). doi: 10.1016/j.jadohealth.2009.06.006
- 15.Hernández-Díaz S, Toh S, Cnattingius S (2009) Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ 18(338):b2255. doi: 10.1136/bmj.b2255
- 18.Taffel S, Johnson D, Heuser R (1982) A method of imputing length of gestation on birth certificates. Vital Health Stat 2:1–11Google Scholar
- 21.Clayton D, Hills M (1993) Statistical models in epidemiology. Oxford University Press, OxfordGoogle Scholar
- 32.Pickett KE, Kasza K, Biesecker G, Wright RJ, Wakschlag LS (2009) Women who remember, women who do not: a methodological study of maternal recall of smoking in pregnancy. Nicotine Tob ResGoogle Scholar