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Clinical manifestation of small-for-gestational-age risk pregnancy from smoking is gestational age dependent
Kerri Fitzgerald1, Jinwen Cai, Gerald Hoff
1Children's Mercy Hospitals and Clinics, Kansas City, MO 64108, US.
To determine the gestational age period at which small-for-gestational-age (SGA) risk from pregnancy smoking manifests, we conducted a retrospective cohort study of 266,782 live births in Kansas City, Missouri, from 1990 to 2004. Information was obtained from birth records. Newborns were stratified by gestation (< 32, 32 to 36, and > or = 37 weeks) and maternal pregnancy smoking. The outcome of interest was SGA. Covariates included factors associated with fetal growth restriction. SGA rates varied (8.4% versus 15.7% versus 9.9%), and relative risk from smoking increased (1.01 versus 1.46 versus 2.22) with gestational age periods. On multivariable logistic regression, smoking increased the odds ratio (OR) of SGA only among infants > or = 32 weeks; OR (95% confidence interval [CI], 1.26 [0.94, 1.68], 1.78 [1.59, 1.99], and 2.62 [2.52, 2.72]), for < 32, 32 to 36, and > or = 37 weeks, respectively. In conclusion, the clinical manifestation of SGA risk from smoking is gestational age dependent, only becoming apparent after 32 weeks of gestation.
To determine the gestational age period at which small-for-gestational-age (SGA) risk from pregnancy smoking manifests, we conducted a retrospective cohort study of 266,782 live births in Kansas City, Missouri, from 1990 to 2004. Information was obtained from birth records. Newborns were stratified by gestation (< 32, 32 to 36, and > or = 37 weeks) and maternal pregnancy smoking. The outcome of interest was SGA. Covariates included factors associated with fetal growth restriction. SGA rates varied (8.4% versus 15.7% versus 9.9%), and relative risk from smoking increased (1.01 versus 1.46 versus 2.22) with gestational age periods. On multivariable logistic regression, smoking increased the odds ratio (OR) of SGA only among infants > or = 32 weeks; OR (95% confidence interval [CI], 1.26 [0.94, 1.68], 1.78 [1.59, 1.99], and 2.62 [2.52, 2.72]), for < 32, 32 to 36, and > or = 37 weeks, respectively. In conclusion, the clinical manifestation of SGA risk from smoking is gestational age dependent, only becoming apparent after 32 weeks of gestation.
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