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Factors potentiating the smoking-related risk of fetal growth retardation
A Spinillo1, E Capuzzo, S E Nicola
1Department of Obstetrics and Gynaecology, University of Pavia, IRCCS San Matteo, Italy.
Objective:
To estimate the risk of fetal growth retardation resulting from the interaction between maternal smoking during pregnancy and other recognized risk factors.
Design:
Case-control study of prospectively recorded data.
Setting:
Department of Obstetrics and Gynaecology, University of Pavia, Italy.
Subjects:
Three hundred and forty-seven singleton pregnancies with diagnosis of fetal growth retardation and 694 control pregnancies with appropriately grown fetuses.
Results:
The overall odds ratio for fetal growth retardation associated with maternal smoking was 2.87 (95% confidence interval, 2.17-3.80). In logistic models the factors which independently increased the smoking-related risk of fetal growth retardation were a male fetus, nulliparity, maternal age 20 years or less, a history of first trimester haemorrhage and low (less than 50 kg) pre-pregnancy weight. The combined effect of smoking and caffeine consumption on the risk of fetal growth retardation was found to be additive rather than multiplicative.
Conclusions:
Several factors can affect the risk of fetal growth retardation associated with maternal smoking. The prenatal identification of these factors could help detect subgroups of women at high risk of fetal growth retardation.