Intrauterine Exposure to Tobacco and Risk of Medically Indicated and Spontaneous Preterm Birth

ABSTRACT

We investigated the association between prenatal smoking and the occurrence of medically indicated and spontaneous preterm delivery (<37 weeks). We performed a retrospective cohort study of singleton live births in the state of Missouri (n = 1,219,159) using maternally linked cohort data files covering the period 1989 to 2005. The main outcomes of interest were spontaneous and medically indicated preterm and very preterm birth. Logistic regression models were used to generate adjusted odds ratios and their 95% confidence intervals. There were 132,246 (10.8%) infants born preterm in the study population, of which 106,410 (80.5%) were classifiable as spontaneous preterm births and 25,836 (19.5%) were medically indicated preterm deliveries. We found elevated risks for both medically indicated and spontaneous preterm birth associated with maternal cigarette smoking during pregnancy. This heightened risk was particularly evident for medically indicated preterm birth (adjusted odds ratio [95% confidence interval] = 1.48 [1.41 to 1.55]). Women who smoke during pregnancy are at increased risk for preterm birth, and especially for medically indicated preterm delivery.

KEYWORDS

Medically indicated preterm birth - spontaneous preterm birth - maternal smoking - singletons - population-based study

REFERENCES

• 1 Polakowski L L, Akinbami L J, Mendola P. Prenatal smoking cessation and the risk of delivering preterm and small-for-gestational-age newborns.  Obstet Gynecol. 2009;  114(2 Pt 1) 318-325
• 2 Aliyu M H, Salihu H M, Wilson R E, Kirby R S. Prenatal smoking and risk of intrapartum stillbirth.  Arch Environ Occup Health. 2007;  62 87-92
• 3 , [No authors listed] Women and smoking: a report of the Surgeon General. Executive summary.  MMWR Recomm Rep. 2002;  51 1-13
• 4 McCormick M C. The contribution of low birth weight to infant mortality and childhood morbidity.  N Engl J Med. 1985;  312 82-90
• 5 Martin J A, Hamilton B E, Sutton P D Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System et al. Births: Preliminary data for 2006.  Natl Vital Stat Rep. 2007;  56 1-18
• 6 Goldenberg R L, Culhane J F, Iams J D, Romero R. Epidemiology and causes of preterm birth.  Lancet. 2008;  371 75-84
• 7 Moutquin J M. Classification and heterogeneity of preterm birth.  BJOG. 2003;  110(Suppl 20) 30-33
• 8 Ananth C V, Vintzileos A M. Epidemiology of preterm birth and its clinical subtypes.  J Matern Fetal Neonatal Med. 2006;  19 773-782
• 9 Tucker J M, Goldenberg R L, Davis R O, Copper R L, Winkler C L, Hauth J C. Etiologies of preterm birth in an indigent population: is prevention a logical expectation?.  Obstet Gynecol. 1991;  77 343-347
• 10 Berkowitz G S, Papiernik E. Epidemiology of preterm birth.  Epidemiol Rev. 1993;  15 414-443
• 11 Martin J, Curtin S, Saulnier M, Mousavi J. Development of the matched multiple birth file. 1995–1998 matched multiple birth dataset. NCHS CD-ROM series 21, No. 13a. Hyattsville, MD; National Center for Health Statistics 2003
• 12 Ananth C V, Kirby R S, Vintzileos A M. Recurrence of preterm birth in twin pregnancies in the presence of a prior singleton preterm birth.  J Matern Fetal Neonatal Med. 2008;  21 289-295
• 13 Salihu H M, Lynch O, Alio A P, Liu J. Obesity subtypes and risk of spontaneous versus medically indicated preterm births in singletons and twins.  Am J Epidemiol. 2008;  168 13-20
• 14 Salihu H M, Aliyu M H, Pierre-Louis B J, Alexander G R. Levels of excess infant deaths attributable to maternal smoking during pregnancy in the United States.  Matern Child Health J. 2003;  7 219-227
• 15 Alexander G R, Himes J H, Kaufman R B, Mor J, Kogan M. A United States national reference for fetal growth.  Obstet Gynecol. 1996;  87 163-168
• 16 Taffel S, Johnson D, Heuser R. A method of imputing length of gestation on birth certificates.  Vital Health Stat 2. 1982;  93 1-11
• 17 Ananth C V, Getahun D, Peltier M R, Salihu H M, Vintzileos A M. Recurrence of spontaneous versus medically indicated preterm birth.  Am J Obstet Gynecol. 2006;  195 643-650
• 18 Kogan M D, Martin J A, Alexander G R, Kotelchuck M, Ventura S J, Frigoletto F D. The changing pattern of prenatal care utilization in the United States, 1981–1995, using different prenatal care indices.  JAMA. 1998;  279 1623-1628
• 19 Alexander G R, Cornely D A. Prenatal care utilization: its measurement and relationship to pregnancy outcome.  Am J Prev Med. 1987;  3 243-253
• 20 Clayton D, Hills M. Statistical Models in Epidemiology. Oxford; Oxford University Press 1993
• 21 Cnattingius S, Granath F, Petersson G, Harlow B L. The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries.  N Engl J Med. 1999;  341 943-948
• 22 Kyrklund-Blomberg N B, Cnattingius S. Preterm birth and maternal smoking: risks related to gestational age and onset of delivery.  Am J Obstet Gynecol. 1998;  179 1051-1055
• 23 Hadley C B, Main D M, Gabbe S G. Risk factors for preterm premature rupture of the fetal membranes.  Am J Perinatol. 1990;  7 374-379
• 24 Meyer M B, Jonas B S, Tonascia J A. Perinatal events associated with maternal smoking during pregnancy.  Am J Epidemiol. 1976;  103 464-476
• 25 Kramer M S. Determinants of low birth weight: methodological assessment and meta-analysis.  Bull World Health Organ. 1987;  65 663-737
• 26 Liabsuetrakul T, Suntharasaj T, Suwanrath C, Leetanaporn R, Rattanaprueksachart R, Tuntiseranee P. Serial translabial sonographic measurement of cervical dimensions between 24 and 34 weeks' gestation in pregnant Thai women.  Ultrasound Obstet Gynecol. 2002;  20 168-173
• 27 Lambers D S, Clark K E. The maternal and fetal physiologic effects of nicotine.  Semin Perinatol. 1996;  20 115-126
• 28 Cogswell M E, Weisberg P, Spong C. Cigarette smoking, alcohol use and adverse pregnancy outcomes: implications for micronutrient supplementation.  J Nutr. 2003;  133(5 Suppl 2) 1722S-1731S
• 29 Meyer M B, Tonascia J A. Maternal smoking, pregnancy complications, and perinatal mortality.  Am J Obstet Gynecol. 1977;  128 494-502
• 30 McCowan L M, Dekker G A, Chan E SCOPE consortium et al. Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study.  BMJ. 2009;  338 b1081
• 31 Pickett K E, Kasza K, Biesecker G, Wright R J, Wakschlag L S. Women who remember, women who do not: a methodological study of maternal recall of smoking in pregnancy.  Nicotine Tob Res. 2009;  , July 28 (Epub ahead of print)
• 32 Kramer M S, McLean F H, Boyd M E, Usher R H. The validity of gestational age estimation by menstrual dating in term, preterm, and postterm gestations.  JAMA. 1988;  260 3306-3308