母亲吸烟与妊娠高血压之间的关联是否取决于胎儿生长情况？
Is the association of maternal smoking and pregnancy-induced hypertension dependent on fetal growth?
作者信息
Peltier Morgan R, Ananth Cande V
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
出版信息
Am J Obstet Gynecol. 2007 Jun;196(6):532.e1-6. doi: 10.1016/j.ajog.2006.12.037.
OBJECTIVE
The risk of pregnancy-induced hypertension (PIH) is decreased by smoking, but the mechanisms remain unclear. Our objective was to determine whether this association is dependent on decreased fetal growth.
METHODS
A population-based, retrospective cohort study in the United States was performed consisting of nulliparous women who delivered a singleton birth (n = 8,025,295) between 1995 and 2002. Fetal growth was defined as birthweight for gestational age and characterized as less than 1, 1-2, 3-4, 5-9, 10-19, ..., 90 or greater centiles. Risk and relative risk of PIH before and after adjusting for confounders were estimated.
RESULTS
Smoking was associated with decreased risk of PIH with up to a 46% decreased risk of PIH for growth-restricted babies (less than the 10th centile). This association, however, decreased with increasing birthweight centile and was nonsignificant at 20th or greater centile among heavy smokers, at 60th or greater centile for moderate, and 80th or greater centile for light smokers.
CONCLUSION
Smoking was primarily associated with decreased risk of PIH among growth-restricted babies.
目的
吸烟可降低妊娠高血压（PIH）风险，但其机制尚不清楚。我们的目的是确定这种关联是否取决于胎儿生长受限。
方法
在美国进行了一项基于人群的回顾性队列研究，研究对象为1995年至2002年间分娩单胎的初产妇（n = 8,025,295）。胎儿生长以出生体重与孕周的关系来定义，并分为小于第1百分位数、第1 - 2百分位数、第3 - 4百分位数、第5 - 9百分位数、第10 - 19百分位数、……、第90百分位数及以上。估计了在调整混杂因素前后PIH的风险和相对风险。
结果
吸烟与PIH风险降低相关，对于生长受限婴儿（小于第10百分位数），PIH风险降低高达46%。然而，这种关联随着出生体重百分位数的增加而减弱，在重度吸烟者中，出生体重在第20百分位数及以上时无显著关联；中度吸烟者在第60百分位数及以上时无显著关联；轻度吸烟者在第80百分位数及以上时无显著关联。
结论
吸烟主要与生长受限婴儿PIH风险降低相关。
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