Høgberg Vibecke, Rasmussen Svein, Irgens Lorentz M
Medical Birth Registry of Norway, Locus of Registry Based Epidemiology, University of Bergen and the Norwegian Institute of Public Health, Bergen, Norway.
Acta Obstet Gynecol Scand. 2007;86(3):304-9. doi: 10.1080/00016340601134572.
To assess the effects of smoking and hypertension on abruptio placentae and whether the effect of hypertension is modified by smoking and vice versa. To quantify the proportion of abruptio placentae cases attributable to hypertension and smoking.
Registry based national cohort study.
814 cases of abruptio placentae among a total of 211,868 births in Norway during the period 1999-2002. Logistic regression analysis was used to assess whether the risk of abruptio placentae is influenced by maternal smoking habits and hypertensive disorders and to evaluate interactions in the effects on abruptio placentae of smoking and hypertension.
In occasionally and daily smokers at the onset of pregnancy, abruptio placentae occurred in 5.4 and 5.7 per 1000, respectively, against 3.4 per 1000 in non-smokers (adjusted odds ratios (ORs) for maternal age and birth order 1.6-1.7). No significant dose-response effect was found. Adjusted ORs for abruptio placentae in women with pre-eclampsia superimposed on chronic hypertension, transient hypertension, mild and severe pre-eclampsia, and pre-eclampsia with onset before 34th weeks of gestation were significantly increased (ORs 1.6-4.1). The combined effects of smoking and hypertensive disorder were additive. Hypertension explained 3.3% of abruptio placentae, while smoking explained 6.9% of abruptio placentae cases.
The effects on abruptio placentae of hypertensive pregnancy disorders and smoking are independent and additive, indicating that smoking and hypertension have their effects though separate mechanisms. If smoking were eliminated in pregnant women, the number of abruptio placentae cases would be reduced by 7%.
评估吸烟和高血压对胎盘早剥的影响，以及高血压的影响是否会因吸烟而改变，反之亦然。量化可归因于高血压和吸烟的胎盘早剥病例比例。
基于登记处的全国队列研究。
1999年至2002年期间，挪威共有211,868例分娩，其中814例胎盘早剥。采用逻辑回归分析评估胎盘早剥风险是否受孕妇吸烟习惯和高血压疾病影响，并评估吸烟和高血压对胎盘早剥影响的相互作用。
妊娠开始时偶尔吸烟和每日吸烟的孕妇，胎盘早剥发生率分别为每1000例中有5.4例和5.7例，而非吸烟者为每1000例中有3.4例（根据产妇年龄和产次调整后的优势比（OR）为1.6 - 1.7）。未发现显著的剂量反应效应。子痫前期合并慢性高血压、短暂性高血压、轻度和重度子痫前期以及妊娠34周前发病的子痫前期患者发生胎盘早剥的调整后OR显著升高（OR为1.6 - 4.1）。吸烟和高血压疾病的联合作用是相加的。高血压导致3.3%的胎盘早剥，而吸烟导致6.9%的胎盘早剥病例。
高血压妊娠疾病和吸烟对胎盘早剥的影响是独立且相加的，表明吸烟和高血压通过不同机制产生影响。如果孕妇戒烟，胎盘早剥病例数将减少7%。
