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Pregnancy outcomes in smokers who develop pre-eclampsia.
Lauren A Beste1, Lucinda J England, Enrique F Schisterman
1Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Paediatric and Perinatal Epidemiology
|January 27, 2005
Summary
Maternal smoking does not worsen pre-eclampsia severity or restrict fetal growth in affected pregnancies. This study found no increased risk of severe disease or synergistic effects on birthweight among smokers who developed pre-eclampsia.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Background:
- Maternal smoking is linked to reduced pre-eclampsia risk but potentially increased adverse outcomes.
- The interplay between smoking and pre-eclampsia clinical manifestations requires further investigation.
Purpose of the Study:
- To investigate the impact of maternal smoking on the clinical presentation and severity of pre-eclampsia.
- To determine if smoking modifies the effects of pre-eclampsia on fetal growth.
Main Methods:
- Analysis of data from the Calcium for Pre-eclampsia Prevention (CPEP) randomized trial involving 4589 nulliparous women.
- Assessment of smoking history at enrollment and monitoring for hypertension, proteinuria, and disease severity.
- Comparison of outcomes between smokers and non-smokers within the pre-eclamptic cohort.
Main Results:
- Among women with pre-eclampsia, maternal smoking was not associated with an increased risk of severe disease (aOR 0.87, 95% CI 0.30-2.51).
- Gestational age at pre-eclampsia onset was similar in smokers and non-smokers (264.8 vs. 268.2 days, P=0.48).
- The reduction in birthweight attributable to smoking was not greater in pre-eclamptic women compared to normotensive women.
Conclusions:
- Maternal smoking during pregnancy is not associated with increased pre-eclampsia severity.
- There is no evidence of a synergistic effect between pre-eclampsia and smoking in restricting fetal growth.