Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia.
Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, SA, Australia.
Med J Aust. 2014 Sep 1;201(5):274-8. doi: 10.5694/mja13.11142.
To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes.
Retrospective cohort study from 1 January 1999 to 31 December 2008.
All singleton births in South Australia.
Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746).
Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy.
Active cigarette smoking during pregnancy was associated with an increased risk of adverse perinatal outcomes, including premature labour (Aboriginal, 1-10 cigarettes per day: aOR, 1.69; 95% CI, 1.28-2.23; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.46; 95% CI, 1.34-1.58), preterm birth (Aboriginal, 1-10 cigarettes per day: aOR, 1.40; 95% CI, 1.14-1.73; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.48; 95% CI, 1.39-1.57), intrauterine growth restriction (Aboriginal, 1-10 cigarettes per day: aOR, 2.33; 95% CI, 1.77-3.08; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.65; 95% CI, 2.48-2.83) and small for gestational age (Aboriginal, 1-10 cigarettes per day: aOR, 2.49; 95% CI, 2.06-3.00; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.29; 95% CI, 2.20-2.40). For both Aboriginal and non-Aboriginal women who smoked 11 or more cigarettes per day the aOR for these outcomes increased. Smoking cessation in the first trimester reduced these risks to levels comparable with non-smokers. The risk of each adverse outcome was greater in Aboriginal than non-Aboriginal women for all smoking categories; however, interactions between Aboriginal status and smoking were not significant, indicating an equal contribution of smoking to poor outcomes in both populations.
Smoking cessation or reduction during pregnancy would significantly improve outcomes in both Aboriginal and non-Aboriginal women. This should be made a clear priority to improve pregnancy outcomes for all women.
评估原住民身份、妊娠期间主动吸烟和戒烟对围产期结局的影响。
1999 年 1 月 1 日至 2008 年 12 月 31 日的回顾性队列研究。
南澳大利亚州所有的单胎分娩。
原住民妇女（n=4245）和非原住民妇女（n=167746）的基于人群的妊娠记录。
根据原住民身份和妊娠期间母亲吸烟情况，调整不良母婴结局的优势比（aOR）和 95%置信区间（CI）。
妊娠期间主动吸烟与不良围产期结局风险增加相关，包括早产（原住民，1-10 支香烟/天：aOR，1.69；95%CI，1.28-2.23；非原住民，1-10 支香烟/天：aOR，1.46；95%CI，1.34-1.58）、早产（原住民，1-10 支香烟/天：aOR，1.40；95%CI，1.14-1.73；非原住民，1-10 支香烟/天：aOR，1.48；95%CI，1.39-1.57）、宫内生长受限（原住民，1-10 支香烟/天：aOR，2.33；95%CI，1.77-3.08；非原住民，1-10 支香烟/天：aOR，2.65；95%CI，2.48-2.83）和小于胎龄儿（原住民，1-10 支香烟/天：aOR，2.49；95%CI，2.06-3.00；非原住民，1-10 支香烟/天：aOR，2.29；95%CI，2.20-2.40）。对于每天吸烟 11 支或更多香烟的原住民和非原住民妇女，这些结局的 aOR 增加。妊娠早期戒烟可将这些风险降低至与不吸烟者相当的水平。对于所有吸烟人群，原住民妇女发生每种不良结局的风险均大于非原住民妇女；然而，原住民身份和吸烟之间的交互作用不显著，这表明吸烟对两个群体的不良结局均有同等贡献。
妊娠期间戒烟或减少吸烟量可显著改善原住民和非原住民妇女的结局。这应该成为一个明确的优先事项，以改善所有妇女的妊娠结局。
