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The effect of smoking on pre‐eclampsia in twin pregnancy
Author(s) -
Martin Christine L.,
Hall Marion H.,
Campbell Doris M.
Publication year - 2000
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2000.tb13335.x
Subject(s) - medicine , obstetrics , eclampsia , pregnancy , miscarriage , incidence (geometry) , twin pregnancy , gestation , gynecology , genetics , physics , optics , biology
Objective To assess the effect of smoking on the incidence of pre‐eclampsia and on perinatal outcome in twin pregnancy. Design Retrospective study using Aberdeen Maternity and Neonatal Databank. Setting Grampian, Orkney and Shetland. Population All 1575 twin pregnancies delivered in the years 1969–1971 and 1976–1997 (when smoking data were available). Methods In all twin pregnancies the effects of smoking on pre‐eclampsia were analysed by parity and gestation at delivery. The effect of smoking upon late miscarriage and perinatal outcome was analysed without subdivision. Main outcome measures Pre‐eclampsia and perinatal outcome. Results Primiparae had significantly higher rates of pre‐eclampsia than multiparae and were'delivered significantly earlier. The incidence of pre‐eclampsia in smokers was significantly lower only in multiparae. Length of gestation was significantly shorter in multiparous smokers. The effect of smoking on pre‐eclampsia appeared to be direct in multiparae but possibly indirect in primiparae (by causing earlier delivery). Smokers had a higher late miscarriage rate than nonsmokers. Conclusions In twin pregnancy the apparent protective effect of smoking against pre‐eclampsia is significant only in multiparae, suggesting that in primiparae the smoking effect is overwhelmed by the other reasons for the development of pre‐eclampsia. Smoking in twin pregnancy is not recommended due to the worse fetal outcome rates.