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Am J Perinatol 2020; 37(13): 1364-1376
DOI: 10.1055/s-0039-1693689
Original Article

Smoking during Pregnancy and Adverse Birth and Maternal Outcomes in California, 2007 to 2016

Anura W.G. Ratnasiri 
1   Benefits Division, California Department of Health Care Services, Sacramento, California
2   Faculty of Science, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland, Australia
,
Lauren Gordon
1   Benefits Division, California Department of Health Care Services, Sacramento, California
,
Ronald A. Dieckmann
3   Pediatrics and Emergency Medicine, University of California San Francisco, San Francisco, California
,
Henry C. Lee
4   Department of Pediatrics, School of Medicine, Stanford University, Stanford, California
,
Steven S. Parry
1   Benefits Division, California Department of Health Care Services, Sacramento, California
,
Vivi N. Arief
2   Faculty of Science, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland, Australia
,
Ian H. DeLacy
2   Faculty of Science, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland, Australia
,
Satyan Lakshminrusimha
5   Department of Pediatrics, University of California Davis, Sacramento, California
,
Ralph J. DiLibero
1   Benefits Division, California Department of Health Care Services, Sacramento, California
,
Kaye E. Basford
2   Faculty of Science, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland, Australia
6   Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia
› Author Affiliations Funding None.
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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 delivery

Authors' 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.


Supplementary Material



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.

 

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