Subscribe to RSS
DOI: 10.1055/s-2001-18366
Georg Thieme Verlag Stuttgart · New York
Rauchen während der Schwangerschaft oder niedriger Sozialstatus. Welches ist das größere Risiko für ein geringes Geburtsgewicht?
Untersuchung mit den Daten der MAS-90-Studie (multizentrische Allergiestudie, 1990)Smoking During Pregnancy or Low Social Status - Which is the Better Predictor for Low Birth Weight?Publication History
Publication Date:
09 November 2001 (online)
Zusammenfassung
Fragestellung
Die Rauchprävalenz von Schwangeren hängt vom Sozialstatus ab. Welchen Einfluss haben intrauterine Tabakexposition und Sozialstatus auf das Geburtsgewicht?
Material und Methodik
Es wurden hierzu die Daten der multizentrischen Allergiestudie von 1990 herangezogen, welche prospektiv in 4 Universitätskliniken und 2 städtischen Krankenhäusern der Bundesrepublik-West durch Fragebogen erhoben wurden. Es konnten 5395 (71 %) im Jahr 1990 geborene Neugeborene und deren Mütter in die Analyse eingeschlossen werden. Die Auswertung erfolgte mittels bivariater und multivariater linearer Regressionsanalyse.
Ergebnisse
28,6 % der befragten Frauen rauchten während der Schwangerschaft. Die Neugeborenen von Frauen mit niedriger Bildung hatten ein niedrigeres Geburtsgewicht als die Neugeborenen von Frauen mit höherer Bildung (p = 0,06). Dieser Effekt wurde verstärkt, wenn die Mütter während der Schwangerschaft geraucht hatten (p < 0,001).
Schlussfolgerung
In Deutschland scheinen die Auswirkungen eines niedrigeren Bildungsstandes auf das Geburtsgewicht geringer zu sein als die der vermeidbaren Einflussgröße Rauchen.
Abstract
Background and Purpose
Smoking prevalence during pregnancy usually depends on social status. Our aim was to evaluate the influence of intrauterine tobacco exposure and social status on birth weight.
Material and Methods
The investigation is based on data from a prospective multicenter atopy study (MAS90) carried out in four University hospitals and two municipal hospitals in Western Germany. We included 5395 (71 %) newborn babies delivered in 1990 and their mothers. Data was supplied by a questionnaire, taken during the first week after childbirth, and analysed using both bivariate and multivariate linear regression.
Results
28.6 % of the interviewed women smoked during pregnancy. Newborns of women with lower educational status weighed less than those of women with higher educational status (p = 0.06). This difference became statistically significant (p < 0.001) in cases were the mother smoked during pregnancy.
Conclusion
In Western Germany the influence of the educational level of pregnant women on their babies' birth weight seems to be smaller than the impact of smoking.
Schlüsselwörter
Rauchen während der Schwangerschaft - Geburtsgewicht - Sozialstatus
Key words
Smoking during pregnancy - Birth weight - Social status
Literatur
- 1 Abel E L. Smoking during pregnancy: a review of effects on growth and developmental offspring. Hum Biol. 1980; 52 593-625
- 2 Berger R, Garnier Y. Die Frühgeburt: Pathogenese, Risikoselektion und präventive Maßnahmen. Geburtshilfe Frauenheilkd. 1999; 59 45-56
- 3 Bergmann R L, Bergmann K E, Lau-Schadensdorf S. et al . Atopic diseases in infancy. The German multicenter atopy study (MAS-90). Pediatr Allergy Immunol. 1994; 5 19-25
- 4 Corrao M A, Guindon G E. et al . Building the evidence base of global tobacco control. Bull World Health Organ. 2000; 78 884-890
- 5 Cnattingius S, Haglund B, Meirik O. Cigarette smoking as risk factor for late fetal and early neonatal death. BMJ. 1988; 297 258-261
- 6 Ernster V, Kaufman N, Nichter M. et al . Women and tobacco: moving from policy to action. Bull World Health Organ. 2000; 78 891-901
- 7 Haglund B, Cnattingius S, Nordström M L. Social differences in late fetal death and infant mortality in Sweden 1985 - 86. Paediatr Perinatal Epidemiol. 1993; 7 33-44
- 8 Haste F M, Brooke O G, Anderson H R. et al . Social determinants of nutrient intake in smokers and non-smokers during pregnancy. J Epidemiol Community Health. 1990; 44 205-209
- 9 Haustein K O. Rauchen, Nikotin und Schwangerschaft. Geburtshilfe Frauenheilkd. 2000; 60 11-19
- 10 Helmert U, Lang P, Cuelenaere B. Rauchverhalten von Schwangeren und Müttern mit Kleinkindern. Soz Praeventiv Med. 1998; 43 51-58
- 11 Himmelberger D U, Brown B W, Cohen E N. Cigarette smoking during pregnancy and the occurrence of spontaneous abortion and congenital abnormality. Am J Epidemiol. 1978; 108 470-479
- 12 Junge B, Nagel M. Das Rauchverhalten in Deutschland. Gesundheitswesen. 1999; 61 Spec No 2 121-125
- 13 Kiel D P, Zhang Y, Hannan M T. et al . The effect of smoking at different life stages on bone mineral density in elderly men and women. Osteoporosis Int. 1996; 6 240-248
- 14 Kleinman J C, Kopstein A. Smoking during Pregnancy. AJPH. 1987; 77 823-825
- 15 Kolås T, Nakling J, Salvesen K A. Smoking during pregnancy increases the risk of preterm births among parous women. Acta Obstet Gynecol Scand. 2000; 79 644-648
- 16 Kramer M S. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987; 65 663-737
- 17 Kramer M S, Séguin L, Lydon J. Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly?. Paediatr Perinatal Epidemiol. 2000; 14 194-210
- 18 Lambers D S, Clark K E. The maternal and fetal physiologic effects of nicotine. Semin Perinatol. 1996; 20 115-126
- 19 Lilja G M. Placenta praevia, maternal smoking and recurrence risk. Acta Obstet Gynecol Scand. 1995; 74 341-345
- 20 Meyer M B, Jonas B S, Tonascia J A. Perinatal events associated with maternal smoking during pregnancy. Am J Epidemiol. 1976; 103 464-476
- 21 Meyer M B, Tonascia J A. Maternal smoking, pregnancy complications, and perinatal mortality. Am J Obstet Gynecol. 1977; 128 494-502
- 22 Naeye R L, Harkness W L, Utts J. Abruptio placentae and perinatal death: a prospective study. Am J Obstet Gynecol. 1977; 128 740-746
- 23 Parker J D, Schoendorf K C, Kiely J L. Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Ann Epidemiol. 1994; 4 271-278
- 24 Peacock J L, Bland J M, Anderson H R. et al . Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. BMJ. 1995; 311 531-535
- 25 Persson P H, Grennert L, Gennser G. et al . A study of smoking and pregnancy with special reference to fetal growth. Acta Obstet Gynecol Scand. 1978; 78 33-39
- 26 Schellscheidt J, Oyen N, Jorch G. Interactions between maternal smoking and other prenatal risk factors for sudden infant death syndrome (SIDS). Acta Paediatrica. 1997; 86 857-863
- 27 Simpson W J. et al . A preliminary report on cigarette smoking and the incidence of prematurity. Am J Obstet Gynecol. 1957; 73 808-815
- 28 Wenderlein J M. Rauchen und Schwangerschaft. Z Ärztl Fortbild (Jena). 1995; 89 467-471
- 29 WHO .The world health report 1999 - Combating the tobacco epidemic. Geneva; World Health Organization 1999: 65-79
- 30 Williams M A, Mittendorf R, Lieberman E. et al . Cigarette smoking during pregnancy in relation to placenta previa. Am J Obstet Gynecol. 1991; 165 (1) 28-32
Constanze Hanna Schaffer
Klinik für Geburtsmedizin, Charité, Campus Virchow-Klinikum
Augustenburger Platz 1
13353 Berlin
Email: constanze.schaffer@charite.de