Bickerstaff Margaret, Beckmann Michael, Gibbons Kristen, Flenady Vicki
Department of O&G, Bundaberg Base Hospital, Australia.
Aust N Z J Obstet Gynaecol. 2012 Feb;52(1):54-8. doi: 10.1111/j.1479-828X.2011.01387.x. Epub 2011 Dec 20.
Smoking in pregnancy is associated with a range of adverse pregnancy outcomes.
To compare adverse pregnancy outcomes for women according to smoking status at the first antenatal visit in an Australian setting.
A retrospective study using routinely collected data of all births between 1997 and 2006 at the Mater Mothers' Hospital Brisbane (MMH). Analysis was undertaken using multivariate logistic regression. The following comparisons were undertaken: (i) smokers versus non-smokers; (ii) recent quitters (quit within the last 12 months) versus smokers; and (iii) recent quitters versus non-smokers. Primary outcome measures were small for gestational age (SGA) <10th customised centile and preterm birth (PTB) <37 weeks.
Between 1997 and 2006, 40,193 women birthed at the MMH. Of these 30,524 (75.9%), for which adequate data were available, were included in the study. The smoking rate at booking was 15.4%. Compared to non-smokers (n = 25,814), women who were smoking at the first visit (n = 4710) were at increased risk of SGA (aOR = 2.26, 95%CI = 2.08-2.47) and PTB (aOR = 1.42, 95%CI = 1.27-1.59). In the subset (7801 births) used for comparisons two and three, compared to smokers (n = 1434), recent quitters (n = 945) were at a decreased risk of SGA (aOR = 0.43, 95%CI = 0.33-0.57) but not PTB (aOR = 0.92. 95%CI = 0.69-1.23). Outcomes for recent quitters and non-smokers (n = 5422) appeared similar.
This study confirms the increased risk of continued smoking in pregnancy. Women who quit prior to or during early pregnancy appear to have similar risk to that of non-smokers.
孕期吸烟与一系列不良妊娠结局相关。
在澳大利亚的环境中，根据首次产前检查时的吸烟状况比较女性的不良妊娠结局。
一项回顾性研究，使用布里斯班 Mater Mothers 医院（MMH）1997 年至 2006 年间所有分娩的常规收集数据。采用多变量逻辑回归进行分析。进行了以下比较：（i）吸烟者与非吸烟者；（ii）近期戒烟者（在过去 12 个月内戒烟）与吸烟者；（iii）近期戒烟者与非吸烟者。主要结局指标为小于胎龄儿（SGA）<第 10 定制百分位数和早产（PTB）<37 周。
1997 年至 2006 年期间，40193 名女性在 MMH 分娩。其中 30524 名（75.9%）有足够数据，被纳入研究。登记时的吸烟率为 15.4%。与非吸烟者（n = 25814）相比，首次就诊时吸烟的女性（n = 4710）发生小于胎龄儿的风险增加（调整后比值比[aOR]=2.26，95%置信区间[CI]=2.08 - 2.47）和早产的风险增加（aOR = 1.42，95%CI = 1.27 - 1.59）。在用于比较二和三的亚组（7801 例分娩）中，与吸烟者（n = 1434）相比，近期戒烟者（n = 945）发生小于胎龄儿的风险降低（aOR = 0.43，95%CI = 0.33 - 0.57），但早产风险未降低（aOR = 0.92，95%CI = 0.69 - 1.23）。近期戒烟者和非吸烟者（n = 5422）的结局相似。
本研究证实孕期持续吸烟风险增加。在孕早期之前或期间戒烟的女性似乎与非吸烟者有相似的风险。
