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Risks of Preterm Delivery and Small for Gestational Age Infants: Effects of Nondaily and Low‐Intensity Daily Smoking During Pregnancy
Author(s) -
Tong Van T.,
England Lucinda J.,
Rockhill Karilynn M.,
D'Angelo Denise V.
Publication year - 2017
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12343
Subject(s) - medicine , pregnancy , gestational age , obstetrics , body mass index , small for gestational age , gestation , population , smoking cessation , marital status , young adult , live birth , demography , gerontology , environmental health , genetics , pathology , sociology , biology
Background Few studies have examined the effects of nondaily smoking or low‐intensity daily smoking and infant outcomes. We examined the associations between preterm delivery and small for gestational age (SGA) infants in relation to both nondaily and daily smoking. Methods We used population‐based data on women who delivered live singleton infants using the 2009–11 Pregnancy Risk Assessment Monitoring System. Women's smoking status in the last 3 months of pregnancy was categorised as nonsmokers, quitters, nondaily smokers (<1 cigarette/day), and daily smokers. Controlling for maternal age, maternal race/ethnicity, education, marital status, prepregnancy body mass index (BMI), trimester of prenatal care entry, parity, and alcohol use, we estimated adjusted prevalence ratios (PR) for the outcomes of preterm delivery (<37 weeks’ gestation) and SGA. Results Of the 88 933 women, 13.1%, 1.7%, and 9.6% of the sample were quitters, nondaily smokers, and daily smokers, respectively, in the last 3 months of pregnancy. While nondaily smoking was not associated with preterm delivery, daily smoking was. However, we found no dose–response relationship with the number of cigarettes smoked per day. Risk of delivering a SGA infant was increased for both nondaily and daily smokers (PR 1.4, 95% CI 1.1, 1.8 and PR 2.0, 95% CI 1.9, 2.2 respectively). Conclusions Nondaily smoking in the last 3 months of pregnancy was associated with an increased risk of delivering a SGA infant. Pregnant women should be counselled that smoking, including nondaily and daily smoking, can adversely affect birth outcomes.