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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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- 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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