Effects of maternal smokeless tobacco use on selected pregnancy outcomes in Alaska Native women: a case–control study

Details

• Alternative Title:
  Acta Obstet Gynecol Scand
• Personal Author:
  ENGLAND, LUCINDA J. ; KIM, SHIN Y. ; SHAPIRO-MENDOZA, CARRIE K. ; WILSON, HOYT G. ; KENDRICK, JULIETTE S. ; SATTEN, GLEN A. ; LEWIS, CLAIRE A. ; TUCKER, MYRA J. ; CALLAGHAN, WILLIAM M.
• Description:
  Objective
  
  To examine the potential effects of prenatal smokeless tobacco use on selected birth outcomes. Design. A population-based, case–control study using a retrospective medical record review.
  
  Population
  
  Singleton deliveries 1997–2005 to Alaska Native women residing in western Alaska.
  
  Methods
  
  Hospital discharge codes were used to identify potential case deliveries and a random control sample. Data on tobacco use and confirmation of pregnancy outcomes were abstracted from medical records for 1123 deliveries. Logistic regression was used to examine associations between tobacco use and pregnancy outcomes. Adjusted odds ratios (OR), 95% confidence intervals (95% CI), and p-values were calculated.
  
  Main outcomes measures
  
  Preterm delivery, pregnancy-associated hypertension, and placental abruption.
  
  Results
  
  In unadjusted analysis, smokeless tobacco use was not significantly associated with pre-term delivery (OR 1.44, 95% CI 0.97–2.15). After adjustment for parity, pre-pregnancy body mass index, and maternal age, the point estimate was attenuated and remained non-significant. No significant associations were observed between smokeless tobacco use and pregnancy-associated hypertension (adjusted OR 0.92, 95% CI 0.56–1.51) or placental abruption (adjusted OR 1.11, 95% CI 0.53–2.33).
  
  Conclusions
  
  Prenatal smokeless tobacco use does not appear to reduce risk of pregnancy-associated hypertension or to substantially increase risk of abruption. An association between smokeless tobacco and pre-term delivery could not be ruled out. Components in tobacco other than nicotine likely play a major role in decreased pre-eclampsia risk in smokers. Nicotine adversely affects fetal neurodevelopment and our results should not be construed to mean that smokeless tobacco use is safe during pregnancy.
  
  
• Subjects:
  Abruptio Placentae Adult Alaska Case-Control Studies Female Humans Hypertension, Pregnancy-Induced Logistic Models Pregnancy Premature Birth Retrospective Studies Tobacco, Smokeless Young Adult

  More +
• Keywords:
  Abruption Cigarettes Pregnancy Pregnancy-associated Hypertension Preterm Delivery Smokeless Tobacco
• Source:
  Acta Obstet Gynecol Scand. 92(6):648-655
• Pubmed ID:
  23551054
• Pubmed Central ID:
  PMC5881106
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  92
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:aab59019cb18af7a6afa4b010c7b46dfe5b29bf25ab214c0105851b7f6ee1aa7
• Download URL:
  https://stacks.cdc.gov/view/cdc/53020/cdc_53020_DS1.pdf
• File Type:
  [PDF - 212.02 KB ]