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Maternal tobacco use and extremely premature birth - a population-based cohort study
Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden..
Karolinska Inst, Dept Womens & Childrens Hlth, Neonatal Res Unit, Stockholm, Sweden.;Karolinska Univ Hosp, Astrid Lindgrens Children Hosp, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden..
Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden..
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2016 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 123, no 12, p. 1938-1946Article in journal (Refereed) Published
Abstract [en]

Objective To study the associations of maternal tobacco use (smoking or use of snuff) and risk of extremely preterm birth, and if tobacco cessation before antenatal booking influences this risk. To study the association between tobacco use and spontaneous or medically indicated onset of delivery. Design Population-based cohort study. Setting Sweden. Population All live singleton births, registered in the Swedish Medical Birth Register, 1999-2012. Methods Odds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis. Main outcome measures Extremely preterm birth (<28 weeks of gestation), very preterm birth (28-31 weeks), moderately preterm birth (32-36 weeks). Results Maternal snuff use (OR 1.58; 95% CI: 1.14-2.21) and smoking (OR 1.61; 95% CI: 1.39-1.87 and OR 1.91; 95% CI: 1.53-2.39 for moderate and heavy smoking, respectively) were associated with an increased risk of extremely preterm birth. When cessation of tobacco use was obtained there was no increased risk of preterm birth. Snuff use was associated with a twofold risk increase of medically indicated extremely preterm birth, whereas smoking was associated with increased risks of both medically indicated and spontaneous extremely preterm birth. Conclusions Snuff use and smoking in pregnancy were associated with increased risks of extremely preterm birth. Women who stopped using tobacco before the antenatal booking had no increased risk. These findings indicate that nicotine, the common substance in cigarettes and snuff, is involved in the mechanisms behind preterm birth. The use of nicotine should be minimized in pregnancy.

Place, publisher, year, edition, pages
2016. Vol. 123, no 12, p. 1938-1946
Keyword [en]
Maternal tobacco use, nicotine, preterm birth, smoking, snuff
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-311201DOI: 10.1111/1471-0528.14213ISI: 000388314800008PubMedID: 27411948OAI: oai:DiVA.org:uu-311201DiVA: diva2:1059075
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-1619 2010-0643
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2017-11-29Bibliographically approved

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