Lewandowska Małgorzata, Więckowska Barbara
Medical Faculty, Lazarski University, 02-662 Warsaw, Poland.
Division of Gynecological Surgery, University Hospital, 33 Polna Str., 60-535 Poznan, Poland.
J Clin Med. 2020 Jun 4;9(6):1743. doi: 10.3390/jcm9061743.
The relationship between smoking and the risk of pregnancy-induced hypertension (PIH) is not clearly established. Therefore, we conducted an analysis of cigarette smoking in a Polish cohort of women, recruited in the first trimester of a single pregnancy in 2015-2016. We evaluated the women who subsequently developed PIH ( = 137) (gestational hypertension-GH ( = 113) and pre-eclampsia-PE ( = 24)), and the women who remained normotensive ( = 775). The diseases odds ratios (and 95% CI-confidence intervals) were calculated in a multivariate logistic regression. In the PIH cases (vs. normotensive women) we found more smokers (25.6% vs 17.2%, = 0.020) including smokers in the first trimester (14.6% vs 4.8%, <0.001). The average number of cigarettes smoked daily per smokers in the first trimester was 11.2 (range 2-30), and the average number of years of smoking was 11.6 (range 2-25). The number of years of smoking was a stronger risk factor for GH and PE than the number of cigarettes/day. Compared to the women who have never smoked, smoking ever before pregnancy was associated with a higher GH risk (AOR = 1.68; = 0.043), and with no effect on PE risk (OR = 0.97; = 0.950). Smokers in the first trimester had a higher odds ratio of GH (AOR = 4.75; <0.001) and PE (OR = 2.60; = 0.136). Quitting smoking before pregnancy (ex-smokers) was associated with a lower odds ratio of GH (AOR = 0.83; = 0.596) and PE (OR = 0.33; = 0.288). However, quitting smoking during pregnancy was associated with a higher risk of GH (AOR = 11.63; <0.0001) and PE (OR = 3.57; = 0.238). After dissection of the cohort into pre-pregnancy body-mass index (BMI) categories, smoking in the first trimester was associated with the higher hypertension risk in underweight women (OR = 22.00, = 0.024). Conclusions: The factors that increased the risk of GH and PE were smoking in the first trimester and (paradoxically and more strongly) smoking cessation during pregnancy. Our results suggest that women of childbearing potential should be encouraged to quit smoking before pregnancy.
吸烟与妊娠高血压（PIH）风险之间的关系尚未明确确立。因此，我们对2015 - 2016年单胎妊娠孕早期招募的波兰女性队列中的吸烟情况进行了分析。我们评估了随后发生PIH的女性（n = 137）（妊娠高血压 - GH（n = 113）和先兆子痫 - PE（n = 24））以及血压正常的女性（n = 775）。在多因素逻辑回归中计算疾病比值比（及95%CI - 置信区间）。在PIH病例中（与血压正常女性相比），我们发现吸烟者更多（25.6%对17.2%，P = 0.020），包括孕早期吸烟者（14.6%对4.8%，P <0.001）。孕早期每位吸烟者每日平均吸烟量为11.2支（范围2 - 30支），平均吸烟年限为11.6年（范围2 - 25年）。吸烟年限对GH和PE来说是比每日吸烟量更强的风险因素。与从未吸烟的女性相比，孕前曾吸烟与更高的GH风险相关（AOR = 1.68；P = 0.043），对PE风险无影响（OR = 0.97；P = 0.950）。孕早期吸烟者发生GH的比值比更高（AOR = 4.75；P <0.001）和PE（OR = 2.60；P = 0.136）。孕前戒烟者（既往吸烟者）发生GH的比值比更低（AOR = 0.83；P = 0.596）和PE（OR = 0.33；P = 0.288）。然而，孕期戒烟与更高的GH风险（AOR = 11.63；P <0.0001）和PE风险（OR = 3.57；P = 0.238）相关。将队列按孕前体重指数（BMI）类别进行剖析后，孕早期吸烟与体重过轻女性中更高的高血压风险相关（OR = 22.00，P = 0.024）。结论：增加GH和PE风险的因素是孕早期吸烟以及（矛盾且更强烈的是）孕期戒烟。我们的结果表明，应鼓励有生育潜力的女性在孕前戒烟。
