Department of General Practice, Institute of Clinical Medicine, University of Turku and Southwest Finland Wellbeing Services County, Turku, Finland.
Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
Acta Obstet Gynecol Scand. 2024 Sep;103(9):1859-1867. doi: 10.1111/aogs.14920. Epub 2024 Jul 14.
Maternal smoking during pregnancy and gestational diabetes mellitus (GDM) have opposite effects on fetal growth during pregnancy. The aim of the study was to evaluate the interaction of smoking during pregnancy and gestational diabetes mellitus on head circumference and birthweight of newborns.
The study included all primiparous women with singleton pregnancies (n = 290 602) without previously diagnosed diabetes or hypertension in Finland between 2006 and 2018. The information on gestational diabetes mellitus, newborn birthweight and head circumference, and maternal smoking and backgrounds was derived from the Finnish Medical Birth Register. Linear regression models were used in the analyses.
In total 8.0% of parturients quit smoking during the first trimester and 9.9% continued smoking thereafter. The prevalence of GDM was 8.9% (n = 25 948). Newborns of women who continued smoking had a smaller head circumference (b = -0.24, SE = 0.01, p < 0.0001) and birthweight (b = -0.28, SE = 0.01, p < 0.0001) compared to newborns of women who did not smoke. Head circumference and birthweight were greater in newborns of women with GDM (b = 0.09, SE = 0.01, p < 0.0001 and b = 0.16, SE = 0.01, p < 0.0001, respectively) compared to newborns of women without GDM. In the interaction analyses, head circumference (b = -0.13, SE = 0.01, p < 0.0001) was smaller and birthweight (b = -0.13, SE = 0.02, p < 0.0001) was lower in newborns of women with GDM who continued smoking compared to newborns of women without GDM who did not smoke.
Although smoking and GDM have opposite effects on fetal growth, the negative effects of exposure to smoking are also seen in newborns of women with GDM. Compared to smoking after the first trimester of pregnancy, cessation of smoking during the first trimester was associated with greater head circumference and birthweight in newborns.
孕妇在怀孕期间吸烟和妊娠糖尿病（GDM）对胎儿在怀孕期间的生长有相反的影响。本研究的目的是评估怀孕期间吸烟和妊娠糖尿病对新生儿头围和出生体重的相互作用。
该研究包括 2006 年至 2018 年期间芬兰所有初次生育的单胎孕妇（n=290602），这些孕妇在之前没有诊断出糖尿病或高血压。妊娠糖尿病、新生儿出生体重和头围以及孕妇吸烟和背景信息均从芬兰医疗出生登记处获得。分析中使用了线性回归模型。
共有 8.0%的产妇在孕早期戒烟，9.9%的产妇继续吸烟。GDM 的患病率为 8.9%（n=25948）。与不吸烟的产妇所生的新生儿相比，继续吸烟的产妇的新生儿头围（b=-0.24，SE=0.01，p<0.0001）和出生体重（b=-0.28，SE=0.01，p<0.0001）更小。与未患 GDM 的产妇所生的新生儿相比，患有 GDM 的产妇的新生儿头围（b=0.09，SE=0.01，p<0.0001）和出生体重（b=0.16，SE=0.01，p<0.0001）更大。在交互分析中，与未患 GDM 的不吸烟产妇所生的新生儿相比，患有 GDM 且继续吸烟的产妇的新生儿头围（b=-0.13，SE=0.01，p<0.0001）更小，出生体重（b=-0.13，SE=0.02，p<0.0001）更低。
尽管吸烟和 GDM 对胎儿生长有相反的影响，但吸烟的负面影响也见于患有 GDM 的产妇的新生儿中。与妊娠早期后吸烟相比，妊娠早期戒烟与新生儿头围和出生体重增加有关。
