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Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study

  • Perinatal Epidemiology
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

This study aimed to analyse the relationship between smoking and preterm birth (22–36 weeks) according to the main obstetric complications leading to the preterm birth, both overall and by parity. The EUROPOP study is a case-control study carried out between 1994 and 1997; 3,787 preterm and 5,602 full-term births were included, from maternity units in 10 countries, using the same protocol. Social, demographic and medical information was collected after delivery, from obstetric records and interviews with the mothers. Cases were classified according to the main obstetric complication (hypertension, haemorrhage, preterm premature rupture of membranes (PPROM), idiopathic spontaneous preterm labour, intrauterine growth retardation, all other causes). Multiple logistic regression analysis was used to control for confounders. Twenty four percent of cases and 20% of controls were smokers. Smoking during pregnancy, heavy smoking (≥10 cigarettes per day) in particular, was a risk factor for preterm birth (aOR = 1.39, 95% CI:1.20–1.60). Smoking increased the risk of preterm delivery due to all obstetric complications other than hypertension. For these complications, the risk of preterm delivery associated with smoking was higher for multiparae (aOR = 1.46, 95% CI:1.24–1.71) than for primiparae (aOR = 1.18, 95% CI:1.00–1.38). In conclusion, smoking during pregnancy increases the risk of preterm birth among women with all obstetric complications except hypertension. This association is stronger in multiparae than in primiparae and the risk is higher for heavy smokers.

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Abbreviations

aOR:

Adjusted odds ratio

BMI:

Body mass index

IUGR:

Intrauterine growth retardation

OR:

Odds ratio

PPROM:

Preterm premature rupture of membranes

SD:

Standard deviation

95% CI:

95 percent confidence interval

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Acknowledgments

We would like to thank the members of the EUROPOP group, the interviewers for data collection, and the technical teams for computerized data handling in all countries. This study was funded by the European Union (contract BMH1-CT94-1041). We thank G. Bréart, E. Papiernik and G. Di Renzo, who coordinated the project, for their helpful comments on the manuscript.

The EUROPOP group: Members of the steering committee: Project leader: Di Renzo GC, Perugia, Italy. Bréart G, MD and Papiernik E, MD, Paris, France; Patel N, MD, Dundee, UK; Saurel-Cubizolles MJ, PhD, Villejuif, France; Taylor D, MD, Leicester, UK; Todini S, MsC, Perugia, Italy. Members of the national staffs: Czech Republic: Kudela M, MD, Vetr M, MD, in Olomouc; Finland: Heikkilä A, MD, Erkkola R, MD, Forström J, MD, in Turku; France: Papiernik E, MD, Lucidarme P, Midwife, in Paris. Tafforeau J, MD, in Brussels; Germany: Künzel W, MD, Herrero-Garcia J, MD, in Giessen; Dudenhausen J, MD, Henrich W, MD, in Berlin; Greece: Antsaklis A, MD, Haritatos G, MD, in Athens; Hungary: Kovacs L, MD, Nyari T, MD, Bartfai G, MD, in Szeged; Ireland: O’Herlihy C, MD, Murphy J, MD, Stewart H, in Dublin; Italy: Di Renzo GC, MD, Bruschettini PL, MD, Moscioni P, MD, in Perugia; Cosmi E, MD, Spinelli A, MsC, Donati S, MD, in Rome; Poland: Breborowicz GH, MD, Anholcer A, MD, in Poznan; Romania: Stamatian F, MD, in Cluj; Russia: Mikhailov AV, MD, in St Petersburg; Slovenia: Pajntar M, MD, Pirc M, MD, Verdenik I, MD, in Ljubljana; Spain: Escriba-Aguir V, MD, in Valencia; Carrera JM, MD, in Barcelona; Sweden: Marsal K, MD, Stale H, MD, in Malmö; The Netherlands: Buitendijk S, PhD, van der Pal K, MsC, in Leiden; van Geijn H, MD, in Amsterdam; Turkey: Gökmen O, MD, Güler C, MD, Caglar T, MD, in Ankara; UK: Owen P, MD, in Dundee.

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Authors and Affiliations

  1. INSERM UMR S149, IFR69, Epidemiological Research Unit on Perinatal and Women’s Health, 16 avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France

    Cathy Nabet, Nathalie Lelong, Pierre-Yves Ancel, Marie-Josèphe Saurel-Cubizolles & Monique Kaminski

  2. Faculty of Dentistry, Paris Descartes University, Montrouge, France

    Cathy Nabet

  3. Tenon University Hospital, 75020, Paris, France

    Pierre-Yves Ancel

  4. Pierre et Marie Curie University-Paris 6, 75012, Paris, France

    Pierre-Yves Ancel

Authors
  1. Cathy Nabet
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  2. Nathalie Lelong
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  3. Pierre-Yves Ancel
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  4. Marie-Josèphe Saurel-Cubizolles
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  5. Monique Kaminski
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Correspondence to Cathy Nabet.

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Nabet, C., Lelong, N., Ancel, PY. et al. Smoking during pregnancy according to obstetric complications and parity: results of the EUROPOP study. Eur J Epidemiol 22, 715–721 (2007). https://doi.org/10.1007/s10654-007-9172-8

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  • DOI: https://doi.org/10.1007/s10654-007-9172-8

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