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- Baba, S, et al.
(författare)
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Changes in snuff and smoking habits in Swedish pregnant women and risk for small for gestational age births
- 2013
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 120:4, s. 456-462
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To examine associations between antenatal exposure to Swedish oral moist snuff (which includes essentially only nicotine) and to smoking and risks of small-for-gestational-age (SGA) births and to compare risks among women who stopped or continued using snuff or smoking during pregnancy.DESIGN:Population-based cohort study.SETTING: Sweden.POPULATION:All live singleton births in Sweden 1999-2010.METHODS:Odds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis.MAIN OUTCOME MEASURES:SGA birth, also stratified into preterm (≤36 weeks of gestation) and term (≥37 weeks of gestation) SGA births.RESULTS: Compared with non-tobacco users in early pregnancy, snuff users and above all smokers in early pregnancy had increased risks of SGA births: adjusted ORs (95% CI) were 1.26 (1.09-1.46) and 2.55 (2.43-2.67), respectively). Snuff use had, if anything, a stronger association with preterm SGA than term SGA, whereas the opposite was true for smoking. Compared with non-tobacco users, women who stopped using snuff before their first visit to antenatal care had no increased risks of preterm or term SGA, and women who stopped using snuff later during pregnancy had no increased risk of term SGA. Smoking cessation early in pregnancy was associated with a larger reduction in risk than smoking cessation later in pregnancy.CONCLUSIONS:As both smoking and snuff use influence risk of SGA, both nicotine but above all tobacco combustion products are involved in the mechanisms by which maternal smoking increases the risk of SGA.
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- Cnattingius, S., et al.
(författare)
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Investigating fetal growth restriction and perinatal risks in appropriate for gestational age infants : using cohort and within-sibling analyses
- 2019
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell Publishing Inc.. - 1470-0328 .- 1471-0528. ; 126:7, s. 842-850
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Fetal growth restriction refers to fetuses that fail to reach their growth potential. Studies within siblings may be useful to disclose fetal growth restriction in appropriate for gestational age (AGA) infants. We analysed associations between birthweight percentiles and perinatal risks in AGA infants, using both population-based and within-sibling analyses.Design: Population-based cohort study. Setting and sample Using nation-wide Swedish registries (1987-2012), we identified 2 134 924 singleton AGA births (10th-90th birthweight percentile for gestational age), of whom 1 377 326 were full siblings.Methods: Unconditional Poisson regression was used for population analyses, and conditional (matched) Poisson regression for within-sibling analyses. We estimated associations between birthweight percentiles and stillbirth, neonatal mortality, and morbidity, using incidence rate ratios (IRRs) with 95% confidence intervals (CIs).Results: Stillbirth and neonatal mortality risks declined with increasing birthweight percentiles, but the declines were larger in within-sibling analyses. Compared with the reference group (40th to <60th percentile), IRRs (95% CIs) of stillbirth for the lowest and highest percentile groups (10th to <25th and 75th-90th percentiles, respectively) were 1.87 (1.72-2.03) to 0.76 (0.68-0.85) in population analysis and 2.60 (2.27-2.98) and 0.43 (0.36-0.50) in within-sibling analysis. Neonatal morbidity risks in term non-malformed infants with low birthweight percentiles were generally only increased in within-sibling analyses.Conclusion: Using birthweight information from siblings may help to define fetal growth restriction in AGA infants.
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- Cnattingius, S, et al.
(författare)
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Rates of metabolic acidosis at birth and Apgar score values at 1, 5, and 10 min in term infants: a Swedish cohort study
- 2020
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Ingår i: Journal of perinatal medicine. - : Walter de Gruyter GmbH. - 1619-3997 .- 0300-5577. ; 48:5, s. 514-515
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMetabolic acidosis, measured in arterial umbilical cord blood at birth, is the most accepted definition of birth asphyxia. The aim of the study was to investigate the rates of metabolic acidosis across the entire range of Apgar score values (0–10) at 1, 5, and 10 min in term infants.MethodsIn a population-based Swedish cohort of births between 2008 and 2013, we included 85,076 term (≥37 weeks) non-malformed infants with information from umbilical arterial blood gas analyses and complete information on Apgar scores (0–10) at 1, 5, and 10 min.ResultsRates of metabolic acidosis generally decreased with increasing Apgar score values. For Apgar score at 1 min, this decrease was consistent from Apgar score 0 (35%) to Apgar score 10 (0%). For Apgar scores at 5 and 10 min, the decrease was consistent for Apgar score values from 6 to 10.ConclusionAlthough there is a close association between Apgar score values and rates of metabolic acidosis, Apgar score is not and should not be used as a measure of birth asphyxia.
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| 43. |
- Dahlin, S., et al.
(författare)
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Maternal tobacco use and extremely premature birth - a population-based cohort study
- 2016
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 123:12, s. 1938-1946
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study the associations of maternal tobacco use (smoking or use of snuff) and risk of extremely preterm birth, and if tobacco cessation before antenatal booking influences this risk. To study the association between tobacco use and spontaneous or medically indicated onset of delivery. Design Population-based cohort study. Setting Sweden. Population All live singleton births, registered in the Swedish Medical Birth Register, 1999-2012. Methods Odds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis. Main outcome measures Extremely preterm birth (<28 weeks of gestation), very preterm birth (28-31 weeks), moderately preterm birth (32-36 weeks). Results Maternal snuff use (OR 1.58; 95% CI: 1.14-2.21) and smoking (OR 1.61; 95% CI: 1.39-1.87 and OR 1.91; 95% CI: 1.53-2.39 for moderate and heavy smoking, respectively) were associated with an increased risk of extremely preterm birth. When cessation of tobacco use was obtained there was no increased risk of preterm birth. Snuff use was associated with a twofold risk increase of medically indicated extremely preterm birth, whereas smoking was associated with increased risks of both medically indicated and spontaneous extremely preterm birth. Conclusions Snuff use and smoking in pregnancy were associated with increased risks of extremely preterm birth. Women who stopped using tobacco before the antenatal booking had no increased risk. These findings indicate that nicotine, the common substance in cigarettes and snuff, is involved in the mechanisms behind preterm birth. The use of nicotine should be minimized in pregnancy.
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| 44. |
- Endler, M., et al.
(författare)
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Retained placenta is associated with pre-eclampsia, stillbirth, giving birth to a small-for-gestational-age infant, and spontaneous preterm birth : a national register-based study
- 2014
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 121:12, s. 1462-1470
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate whether defective placentation disorders, i.e. pre-eclampsia, stillbirth, small for gestational age (SGA), and spontaneous preterm birth, are associated with risk of retained placenta. DesignPopulation-based cohort study. SettingSweden. PopulationPrimiparous women in Sweden with singleton vaginal deliveries between 1997 and 2009 at 32-41weeks of gestation (n=386607), without placental abruption or infants with congenital malformations. MethodsRisks were calculated as odds ratios (ORs) by unconditional logistic regression with 95% confidence intervals (95%CIs) after adjustments for maternal, delivery, and infant characteristics. Main outcome measureRetained placenta, defined by the presence of both a diagnostic code (of retained placenta) and a procedure code (for the manual removal of the placenta). ResultsThe overall rate of retained placenta was 2.17%. The risk of retained placenta was increased for women with pre-eclampsia (adjusted OR, aOR, 1.37, 95%CI 1.21-1.54), stillbirth (aOR1.71, 95%CI 1.28-2.29), SGA birth (aOR1.47, 95%CI 1.28-1.70), and spontaneous preterm birth (32-34weeks of gestation, aOR2.35, 95%CI 1.97-2.81; 35-36weeks of gestation, aOR1.55, 95%CI 1.37-1.75). The risk was further increased for women with preterm pre-eclampsia (aOR1.69, 95%CI 1.25-2.28) and preterm SGA birth (aOR2.19, 95%CI 1.42-3.38). There was no association between preterm stillbirth (aOR1.10, 95%CI 0.63-1.92) and retained placenta, but the exposed group comprised only 15 cases. ConclusionsDefective placentation disorders are associated with an increased risk of retained placenta. Whether these relationships indicate a common pathophysiology remains to be investigated.
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- Hellerstedt, W. L., et al.
(författare)
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Are prenatal, obstetric, and infant complications associated with postpartum psychosis among women with pre-conception psychiatric hospitalisations?
- 2013
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 120:4, s. 446-455
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine the associations of maternal and infant complications with postpartum hospitalisation for psychosis in women with a pre-conception history of psychiatric hospitalisation. Design Population-based study. Setting Swedish medical birth register. Population Primiparous women who gave birth between 1January1987 and 31December2001, and who had a pre-conception history of psychiatric hospitalisation but who were not hospitalised during pregnancy (n=1842). Methods International Classification of Diseases (ICD) codes were used to identify prenatal, obstetric, postpartum maternal complications, and newborn health conditions. We used multivariable logistic regression to describe the associations between maternal and infant health conditions and the odds for postpartum hospitalisation for psychosis. Main outcome measure Psychiatric hospitalisation within 90days of delivery. Results Compared with women who did not have a postpartum psychiatric hospitalisation, hospitalised women were at 2.3 times higher odds (95%CI 1.04.9) of having non-psychiatric puerperium complications (e.g. infection, lactation problems or venous complications). No other maternal complications were associated with postpartum psychiatric hospitalisation. Although their infants were at no higher odds for health complications, the offspring of women who had a postpartum psychiatric hospitalisation were at 4.1 times higher odds (95%CI 1.312.6) of death within the first 365days of life than those of women who were not hospitalised. Conclusions We found no prenatal indicators of postpartum risk for psychiatric hospitalisation among high-risk women, but they had higher odds of postpartum pregnancy-related medical problems and, rarely, offspring death.
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