Brink Lucy T, Nel Daan G, Hall David R, Odendaal Hein J
Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
Department of Statistics and Actuarial Science, Stellenbosch University, South Africa.
J Womens Health Care Manag. 2021;2(2). doi: 10.47275/2692-0948-121. Epub 2021 Mar 27.
The extent to which smoking and drinking in a local community is associated with nutrition and Z-scores of infants from spontaneous preterm deliveries, is uncertain.
To investigate associations of different levels of maternal smoking and drinking in spontaneous preterm birth with infant birthweight Z-scores.
Information, including gestational age (determined by earliest ultrasound), maternal arm circumference (measured at enrolment), smoking-drinking data (obtained up to 4 occasions), birthweight data (obtained from medical records) and birthweight Z-scores (calculated from INTERGROWTH- 21st study), collected over a period of nine years was used to compare 407 spontaneous preterm births with 3 493 spontaneous term births Analyses of variance, correlations and multiple regression were performed in STATISTICA.
Women with spontaneous preterm birth, had significantly lower gravidity and smaller arm circumference when compared to women with spontaneous birth at term. Women with spontaneous preterm birth drank more and heavier during pregnancy, and more smoked. Gestational age at birth was significantly longer in heavy-smokers-heavy-drinkers compared to heavy-smokers-no-drinkers (7.1 days) and in no-smokers-heavy-drinkers when compared to no-smokers-no-drinkers (11.2 days). Birthweight was significantly lower in low-smokers-heavy-drinkers when compared to low-smokers-no-drinkers (240g) and in heavy-smokers-low-drinkers when compared to no-smokers-low-drinkers (273g). Birthweight Z-scores were significantly lower in low-smokers-heavy-drinkers when compared to low-smokers-low-drinkers and low-smokers-no-drinkers; and, also significantly lower in heavy-smokers-low-drinkers when compared to low-smokers-low-drinkers and no-smokers-low-drinkers.
Alcohol aggravates the detrimental effect of smoking on birthweight and birthweight Z-scores but seems to counteract the negative association of smoking with gestational age.
当地社区吸烟和饮酒与自然早产婴儿的营养及Z评分之间的关联程度尚不确定。
研究自然早产中不同水平的母亲吸烟和饮酒与婴儿出生体重Z评分之间的关联。
收集了长达九年的信息，包括孕周（通过最早的超声确定）、母亲上臂围（登记时测量）、吸烟饮酒数据（最多收集4次）、出生体重数据（从医疗记录中获取）以及出生体重Z评分（根据INTERGROWTH-21st研究计算），用于比较407例自然早产与3493例自然足月产。在STATISTICA中进行方差分析、相关性分析和多元回归分析。
与自然足月产的女性相比，自然早产的女性妊娠次数显著更低，上臂围更小。自然早产的女性在孕期饮酒更多、饮酒量更大，且吸烟更多。与重度吸烟者不饮酒者相比，重度吸烟者重度饮酒者的出生孕周显著更长（7.1天）；与不吸烟者不饮酒者相比，不吸烟者重度饮酒者的出生孕周显著更长（11.2天）。与轻度吸烟者不饮酒者相比，轻度吸烟者重度饮酒者的出生体重显著更低（240克）；与不吸烟者轻度饮酒者相比，重度吸烟者轻度饮酒者的出生体重显著更低（273克）。与轻度吸烟者轻度饮酒者和轻度吸烟者不饮酒者相比，轻度吸烟者重度饮酒者的出生体重Z评分显著更低；与轻度吸烟者轻度饮酒者和不吸烟者轻度饮酒者相比，重度吸烟者轻度饮酒者的出生体重Z评分也显著更低。
酒精会加重吸烟对出生体重和出生体重Z评分的有害影响，但似乎抵消了吸烟与孕周之间的负相关。
