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Am J Perinatol 2015; 32(12): 1105-1111
DOI: 10.1055/s-0035-1548728
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Adverse Impact of Maternal Cigarette Smoking on Preterm Infants: A Population-Based Cohort Study

Tetsuya Isayama
1   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
2   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
,
Prakesh S. Shah
1   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
2   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
,
Xiang Y. Ye
2   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
,
Michael Dunn
1   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
,
Orlando Da Silva
3   Department of Paediatrics, University of Western Ontario, London, Ontario, Canada
,
Ruben Alvaro
4   Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
,
Shoo K. Lee
1   Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
2   Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

22 August 2014

12 February 2015

Publication Date:
31 March 2015 (online)

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Abstract

Objective The aim of the study is to examine the impact of exposure to maternal cigarette smoking on neonatal outcomes of very preterm infants.

Study Design A retrospective cohort study examined preterm infants (< 33 weeks gestational age) admitted to the Canadian Neonatal Network centers between 2003 and 2011. Mortality and major morbidities (bronchopulmonary dysplasia, severe intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy) were compared between infants exposed and unexposed to maternal smoking during pregnancy after adjusting for confounders.

Results Among 29,051 study infants, 4,053 (14%) were exposed to maternal smoking during pregnancy. Multivariable analysis revealed higher odds of grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia (adjusted odds ratio [OR]: 1.21, 95% confidence interval [CI]: 1.04–1.41) and bronchopulmonary dysplasia (adjusted OR: 1.16, 95% CI: 1.02–1.33) in the smoking group, while mortality, severe retinopathy, and necrotizing enterocolitis were not significantly different.

Conclusion Maternal smoking during pregnancy is associated with severe neurological injury and bronchopulmonary dysplasia in preterm infants.

Keywords

pregnancy - smoking - preterm infants - morbidity - cohort study
 

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