Aagaard-Tillery Kjersti M, Porter T Flint, Lane Robert H, Varner Michael W, Lacoursiere D Yvette
Division of Maternal-Fetal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Am J Obstet Gynecol. 2008 Jan;198(1):66.e1-6. doi: 10.1016/j.ajog.2007.06.078.
The objective of the study was to evaluate whether maternal tobacco use is associated with an attenuation in fetal birthweight among women with nutritional and uteroplacental constraints.
A population-based retrospective analysis of term (37 weeks or longer) singleton pregnancies delivered in Utah from 1991 to 2001. Birthweight (BW) and percent small for gestational age (SGA) (less than 10% for gestational age) among self-identified smokers and nonsmokers were compared. Adjusted odds ratios (ORs) were calculated to measure the association of maternal smoking with delivery of an SGA infant controlling for potential confounders across maternal strata.
Among the 424,912 gestations, 37,076 occurred in self-identified smokers. Mean BW was significantly less and the prevalence of SGA infants was significantly greater in tobacco-exposed infants across all maternal BMI strata (P < .001) as well as pregnancies complicated by diabetes (P < .001) and hypertensive disorders (P < .001). In a multivariable logistic regression model, tobacco exposure remained the significant associative factor for SGA (OR 3.53, 95% confidence interval 2.61 to 4.79) after selecting for the first birth in the study interval (n = 283,916).
Self-identified tobacco use increases the risk of a SGA infant at term across maternal strata.
本研究的目的是评估在存在营养和子宫胎盘限制因素的女性中，孕期吸烟是否与胎儿出生体重减轻有关。
对1991年至2001年在犹他州分娩的足月（37周或更长时间）单胎妊娠进行基于人群的回顾性分析。比较了自我认定的吸烟者和非吸烟者的出生体重（BW）和小于胎龄儿（SGA）百分比（小于胎龄的10%）。计算调整后的比值比（OR），以衡量孕期吸烟与小于胎龄儿分娩之间的关联，并对各母体层的潜在混杂因素进行控制。
在424,912例妊娠中，37,076例发生在自我认定的吸烟者中。在所有母体体重指数层（P <.001）以及合并糖尿病（P <.001）和高血压疾病（P <.001）的妊娠中，暴露于烟草的婴儿的平均出生体重显著更低，小于胎龄儿的患病率显著更高。在多变量逻辑回归模型中，在研究期间选择首次分娩（n = 283,916）后，烟草暴露仍然是小于胎龄儿的显著关联因素（OR 3.53，95%置信区间2.61至4.79）。
自我认定的孕期吸烟会增加各母体层足月分娩小于胎龄儿的风险。
