Subscribe to RSS
DOI: 10.1055/s-0039-1693689
Smoking during Pregnancy and Adverse Birth and Maternal Outcomes in California, 2007 to 2016
Funding None.![](https://www.thieme-connect.de/media/ajp/202013/lookinside/thumbnails/10-1055-s-0039-1693689_190293-1.jpg)
Abstract
Objective This study aimed to determine associations between maternal cigarette smoking and adverse birth and maternal outcomes.
Study Design This is a 10-year population-based retrospective cohort study including 4,971,896 resident births in California. Pregnancy outcomes of maternal smokers were compared with those of nonsmokers. The outcomes of women who stopped smoking before or during various stages of pregnancy were also investigated.
Results Infants of women who smoked during pregnancy were twice as likely to have low birth weight (LBW) and be small for gestational age (SGA), 57% more likely to have very LBW (VLBW) or be a preterm birth (PTB), and 59% more likely to have a very PTB compared with infants of nonsmokers. During the study period, a significant widening of gaps developed in both rates of LBW and PTB and the percentage of SGA between infants of maternal smokers and nonsmokers.
Conclusion Smoking during pregnancy is associated with a significantly increased risk of adverse birth and maternal outcomes, and differences in rates of LBW, PTB, and SGA between infants of maternal smokers and nonsmokers increased during this period. Stopping smoking before pregnancy or even during the first trimester significantly decreased the infant risks of LBW, PTB, SGA, and the maternal risk for cesarean delivery.
Keywords
smoking during pregnancy - low birth weight - preterm birth - intrauterine growth restriction - small for gestational age - cesarean deliveryAuthors' Contributions
A.W.G.R. conceptualized and designed the study, drafted the initial manuscript, conducted all statistical models, designed the methodology, performed the statistical analysis, and reviewed and revised the manuscript. L.G. reviewed literature, reviewed and revised the manuscript and coordinated all communication and the author's participation. R.A.D. drafted the manuscript, critically reviewed the manuscript for intellectual content, and acted as a subject matter expert. H.C.L., S.S.P., and S.L. reviewed and revised the manuscript and acted as subject matter experts. V.N.A., I.H.D, and R.J.D. reviewed and revised the manuscript and acted as subject matter experts for statistical models. K.E.B. supervised every aspect of the study, provided support in conceptualizing and designing the study, and critically reviewed and revised the manuscript. All authors approved the final manuscript and agree to be accountable for all aspects of the work.
Publication History
Received: 20 May 2019
Accepted: 14 June 2019
Article published online:
31 July 2019
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
-
References
- 1 ACOG. Committee Opinion No. 721 Summary: smoking cessation during pregnancy. Obstet Gynecol 2017; 130 (04) 929-930
- 2 Office of the Surgeon General, Office on Smoking and Health. Reports of the Surgeon General. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2004
- 3 Lurie S, Ribenzaft S, Boaz M, Golan A, Sadan O. The effect of cigarette smoking during pregnancy on mode of delivery in uncomplicated term singleton pregnancies. J Matern Fetal Neonatal Med 2014; 27 (08) 812-815
- 4 National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Reports of the Surgeon General. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2014
- 5 Cnattingius S. The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res 2004; 6 (02) (Suppl. 02) S125-S140
- 6 Jauniaux E, Burton GJ. Morphological and biological effects of maternal exposure to tobacco smoke on the feto-placental unit. Early Hum Dev 2007; 83 (11) 699-706
- 7 National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Center for Disease Control and Prevention; 2014
- 8 Eriksen M, Ross H, Schluger N, Gomeshtapeh F, Drope J. The Tobacco Atlas. 5th ed. Atlanta, GA: American Cancer Society; 2015
- 9 Dempsey DA, Benowitz NL. Risks and benefits of nicotine to aid smoking cessation in pregnancy. Drug Saf 2001; 24 (04) 277-322
- 10 Andres RL, Day MC. Perinatal complications associated with maternal tobacco use. Semin Neonatol 2000; 5 (03) 231-241
- 11 Burton GJ, Palmer ME, Dalton KJ. Morphometric differences between the placental vasculature of non-smokers, smokers and ex-smokers. Br J Obstet Gynaecol 1989; 96 (08) 907-915
- 12 Vardavas CI, Chatzi L, Patelarou E. et al. Smoking and smoking cessation during early pregnancy and its effect on adverse pregnancy outcomes and fetal growth. Eur J Pediatr 2010; 169 (06) 741-748
- 13 Pereira PP, Da Mata FA, Figueiredo AC, de Andrade KR, Pereira MG. Maternal active smoking during pregnancy and low birth weight in the Americas: a systematic review and meta-analysis. Nicotine Tob Res 2017; 19 (05) 497-505
- 14 Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM. Infant morbidity and mortality attributable to prenatal smoking in the U.S. Am J Prev Med 2010; 39 (01) 45-52
- 15 Curtin SC, Matthews TJ. Smoking prevalence and cessation before and during pregnancy: data from the Birth Certificate, 2014. Natl Vital Stat Rep 2016; 65 (01) 1-14
- 16 Duryea EL, McIntire DD, Leveno KJ. The rate of preterm birth in the United States is affected by the method of gestational age assignment. Am J Obstet Gynecol 2015; 213 (02) 231.e1-231.e5
- 17 Ratnasiri AWG, Parry SS, Arief VN. et al. Recent trends, risk factors, and disparities in low birth weight in California, 2005-2014: a retrospective study. Matern Health Neonatol Perinatol 2018; 4 (01) 15
- 18 Reichman NE, Hamilton ER, Hummer RA, Padilla YC. Racial and ethnic disparities in low birthweight among urban unmarried mothers. Matern Child Health J 2008; 12 (02) 204-215
- 19 World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii
- 20 Martin JA, Osterman MJ, Kirmeyer SE, Gregory EC. Measuring gestational age in vital statistics data: transitioning to the obstetric estimate. Natl Vital Stat Rep 2015; 64 (05) 1-20
- 21 Richards JL, Kramer MS, Deb-Rinker P. et al. Temporal trends in late preterm and early term birth rates in 6 high-income countries in North America and Europe and association with clinician-initiated obstetric interventions. JAMA 2016; 316 (04) 410-419
- 22 Thun MJ, Carter BD, Feskanich D. et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med 2013; 368 (04) 351-364
- 23 Blatt K, Moore E, Chen A, Van Hook J, DeFranco EA. Association of reported trimester-specific smoking cessation with fetal growth restriction. Obstet Gynecol 2015; 125 (06) 1452-1459
- 24 Mei-Dan E, Walfisch A, Weisz B, Hallak M, Brown R, Shrim A. The unborn smoker: association between smoking during pregnancy and adverse perinatal outcomes. J Perinat Med 2015; 43 (05) 553-558
- 25 Shah NR, Bracken MB. A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol 2000; 182 (02) 465-472
- 26 Institute of Medicine Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press; 2007
- 27 Clifford A, Lang L, Chen R. Effects of maternal cigarette smoking during pregnancy on cognitive parameters of children and young adults: a literature review. Neurotoxicol Teratol 2012; 34 (06) 560-570
- 28 Peleg D, Kennedy CM, Hunter SK. Intrauterine growth restriction: identification and management. Am Fam Physician 1998; 58 (02) 453-460
- 29 Reeves S, Bernstein I. Effects of maternal tobacco-smoke exposure on fetal growth and neonatal size. Expert Rev Obstet Gynecol 2008; 3 (06) 719-730
- 30 Ludvigsson JF, Lu D, Hammarström L, Cnattingius S, Fang F. Small for gestational age and risk of childhood mortality: a Swedish population study. PLoS Med 2018; 15 (12) e1002717
- 31 Phelan JP. Diminished fetal reactivity with smoking. Am J Obstet Gynecol 1980; 136 (02) 230-233
- 32 Grangé G, Pannier E. Effect of smoking on mode of delivery and per partum hypoxia and acidosis [in French]. J Gynecol Obstet Biol Reprod (Paris) 2005; 34 (Spec No 1): S146-S151
- 33 Molina G, Weiser TG, Lipsitz SR. et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA 2015; 314 (21) 2263-2270
- 34 Schneider S, Schütz J. Who smokes during pregnancy? A systematic literature review of population-based surveys conducted in developed countries between 1997 and 2006. Eur J Contracept Reprod Health Care 2008; 13 (02) 138-147
- 35 Mathews TJ. Smoking during pregnancy in the 1990s. Natl Vital Stat Rep 2001; 49 (07) 1-14
- 36 Wong M, Koren G. Bias in maternal reports of smoking during pregnancy associated with fetal distress. Can J Public Health 2001; 92 (02) 109-112
- 37 Brown QL, Sarvet AL, Shmulewitz D, Martins SS, Wall MM, Hasin DS. Trends in marijuana use among pregnant and nonpregnant reproductive-aged women, 2002–2014. JAMA 2017; 317 (02) 207-209
- 38 Schroeder SA. Heavier but healthier - diabetes and smoking cessation. N Engl J Med 2018; 379 (07) 684-685