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Influence of smoking and snuff cessation on risk of preterm birth

  • PERINATAL EPIDEMIOLOGY
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Abstract

The mechanisms by which antenatal smoking exposure increases the risk of preterm birth remain unknown. Swedish oral moist snuff contains quantities of nicotine comparable to those typically absorbed from cigarette smoking, but does not result in exposure to the products of combustion, for example carbon monoxide. In a nation-wide study of 776,836 live singleton births in Sweden from 1999 to 2009, the authors used multiple logistic regression models to examine associations between cessation of smoking and Swedish snuff use early in pregnancy and risk of preterm birth (before 37 weeks). Compared with non-tobacco users both before and in early pregnancy, the adjusted odds ratios (OR), 95 % confidence interval (CI) were OR = 0.92, 95 % CI 0.84–1.01, for women who stopped using snuff, and OR = 0.90, 95 % CI 0.87–0.94, for women who stopped smoking. In contrast, continued snuff use and smoking were associated with increased risks of preterm birth (adjusted OR = 1.29, 95 % CI 1.17–1.43, adjusted OR = 1.30, 95 % CI 1.25–1.36, respectively). The snuff and smoking-related risks were, if anything, higher for very (before 32 weeks) than moderately (32–36 weeks) preterm birth, and also higher for spontaneous than induced preterm birth. These findings suggest that antenatal exposure to nicotine is involved in the mechanism by which tobacco use increase the risk of preterm birth.

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Acknowledgments

Sachiko Baba is a recipient of Institutional Program for Young Researcher Overseas Visits granted for Public Health, the Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine by the Japan Society of Promotion of Science. The study was supported by grants from the Swedish Council for Working Life and Social Research (2009–1619) and by grants from Karolinska Institutet.

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Correspondence to Sachiko Baba.

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Baba, S., Wikström, AK., Stephansson, O. et al. Influence of smoking and snuff cessation on risk of preterm birth. Eur J Epidemiol 27, 297–304 (2012). https://doi.org/10.1007/s10654-012-9676-8

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  • DOI: https://doi.org/10.1007/s10654-012-9676-8

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