Department of Nursing Science, University of Eastern Finland, P,O,Box, 1627, 70211 Kuopio, Finland.
BMC Public Health. 2013 Dec 13;13:1179. doi: 10.1186/1471-2458-13-1179.
Smoking during pregnancy is known to negatively affect pregnancy outcomes and it has been associated with numerous complications during pregnancy. Smoking is more common in younger pregnant women, but previous research has shown that adverse pregnancy outcomes related to older maternal age and smoking are even more harmful than with younger smokers. The aim of this study was to compare pregnancy outcomes among smoking and non-smoking pregnant women aged <35 years and ≥35 years.
In this registry-based study, the data were collected from three national Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register, and Register of Congenital Malformations between the years 1997 and 2008. The data included information on 80 260 women who were smoking during pregnancy, of which 11 277 (9%) were ≥35 years and 68 983 (13%) were <35 years old. In multivariate modelling, the main outcome measures were preterm delivery, low Apgar scores at 1 min., low birth weight, small for gestational age, fetal death and preeclampsia.
Fewer older women smoked during pregnancy (9%) than younger women did (13%). Smoking increased the risk of adverse pregnancy outcomes, most in the older group. Multivariate logistic regression using non-smoking women aged <35 years as a reference group indicated that smoking women <35 years had higher rates of preterm delivery (OR 1.27 CI 1.20-1.35), SGA (OR 2.18 CI 2.10-2.26) and LBW (OR 1.73 CI 1.62-1.84).Non-smoking women ≥35 had higher rates of preterm delivery (OR 1.15 CI 1.10-1.20), fetal death (OR 1.36 CI 1.12-1.64), preeclampsia (OR 1.14 CI 1.09-1.20) and LBW (OR 1.13 CI 1.07-1.19).Smoking women ≥35 had higher rates of preterm delivery (OR 1.60 CI 1.40-1.82), SGA (OR 2.55 CI 2.34-2.79), fetal death (OR 2.70 CI 1.80-4.05) and LBW (OR 2.50 CI 2.20-2.80).
Smoking during pregnancy increased the risk of adverse pregnancy outcomes in all women, but the rates were the highest for women aged ≥35 years. Pregnant women aged ≥35 years smoking during pregnancy was a distinctly high risk group. Maternity care should identify these women and support them in cessation of smoking during the first trimester of pregnancy.
众所周知，怀孕期间吸烟会对妊娠结局产生负面影响，并且与怀孕期间的许多并发症有关。吸烟在年轻孕妇中更为常见，但先前的研究表明，与年轻吸烟者相比，与年龄较大的母亲和吸烟相关的不良妊娠结局甚至更为有害。本研究旨在比较<35 岁和≥35 岁吸烟和不吸烟孕妇的妊娠结局。
在这项基于注册的研究中，数据来自三个芬兰全国健康登记处：芬兰医疗出生登记处、芬兰住院病人出院登记处和先天性畸形登记处，时间范围为 1997 年至 2008 年。数据包括 80260 名怀孕期间吸烟的妇女的信息，其中 11277 名（9%）年龄≥35 岁，68983 名（13%）年龄<35 岁。在多变量建模中，主要结局指标是早产、1 分钟时低 Apgar 评分、低出生体重、小于胎龄儿、胎儿死亡和子痫前期。
年龄较大的女性（9%）怀孕期间吸烟的比例低于年轻女性（13%）。吸烟增加了不良妊娠结局的风险，在年龄较大的组中更为明显。使用<35 岁不吸烟的女性作为参考组的多变量逻辑回归表明，<35 岁吸烟的女性早产率更高（OR 1.27，95%CI 1.20-1.35）、SGA（OR 2.18，95%CI 2.10-2.26）和 LBW（OR 1.73，95%CI 1.62-1.84）。≥35 岁不吸烟的女性早产率更高（OR 1.15，95%CI 1.10-1.20）、胎儿死亡（OR 1.36，95%CI 1.12-1.64）、子痫前期（OR 1.14，95%CI 1.09-1.20）和 LBW（OR 1.13，95%CI 1.07-1.19）。≥35 岁吸烟的女性早产率更高（OR 1.60，95%CI 1.40-1.82）、SGA（OR 2.55，95%CI 2.34-2.79）、胎儿死亡（OR 2.70，95%CI 1.80-4.05）和 LBW（OR 2.50，95%CI 2.20-2.80）。
怀孕期间吸烟会增加所有女性不良妊娠结局的风险，但对于年龄≥35 岁的女性来说，风险最高。年龄≥35 岁的吸烟孕妇是一个明显的高危群体。产妇保健机构应确定这些妇女，并在妊娠早期支持她们戒烟。
