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Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes
M G Newman1, M K Lindsay, W Graves
1Department of Gynecology and Obstetrics, Emory University School of Medicine and Maternal Fetal Medicine Center, Woman's Hospital of Baton Rouge, Louisiana 70815, USA. mgnewman1@home.com
Objective:
To determine the effects of smoking on pre-eclampsia in an inner-city, predominantly African-American prenatal population.
Methods:
We performed a retrospective cohort study of all primigravidas who delivered singletons in our institution between 1980 and 1989. The study population consisted of 1862 smokers and 16,508 non-smokers. Univariate analysis and multiple logistic regression were used to identify relationships between smoking and adverse outcomes.
Results:
The pre-eclampsia rate was significantly lower among smokers (11.3% vs. 13.0%, OR 0.85, 95% CI 0.73-0.99). Smokers with pre-eclampsia had higher rates of infants with low birth weight (OR 1.44, 95% CI 1.26-1.65) and very low birth weight (OR 1.85, 95% Cl 1.55-2.20) and higher rates of placental abruption (OR 3.49, 95% CI 1.65-7.28) compared to non-smoking pre-eclamptics. This relationship persisted after correction for age, race, chronic hypertension and pre-eclampsia as confounding variables.
Conclusions:
Cigarette smoking was associated with a lower rate of pre-eclampsia among primigravidas independently of other maternal factors. Perinatal outcomes were significantly worsened among pre-eclamptics who smoked.
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