Cosson Emmanuel, Tatulashvili Sopio, Vicaut Eric, Carbillon Lionel, Bihan Hélène, Rezgani Imen, Pinto Sara, Sal Meriem, Zerguine Mohamed, Fermaut Marion, Portal Jean-Jacques, Puder Jardena J, Benbara Amélie
AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France.
INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, 93017 Bobigny, France.
J Clin Med. 2024 Aug 30;13(17):5149. doi: 10.3390/jcm13175149.
We aimed to explore the still-debated association between smoking and hyperglycaemia in pregnancy (HIP). A multiethnic prospective study of 15,801 women who delivered at Jean Verdier University Hospital between 2012 and 2018. Of these, 13,943 (88.2%) were non-smokers, 624 (4.5%) former smokers, and 1234 (7.8%) current smokers. Universal HIP screening was proposed to the entire sample (IADPSG/WHO criteria). A total of 13,958 women were screened for HIP. Uptake differed between non-smokers, former smokers, and current smokers (89.5%, 88.3%, and 75.7%, respectively, < 0.0001). HIP prevalence in these groups was 19.9%, 15.4%, and 12.3%, respectively ( < 0.0001). After adjusting for age, body mass index, family history of diabetes, history of HIP, history of macrosomic baby, and ethnicity, current (odds ratio 0.790 [95% confidence interval 0.636-0.981], < 0.05) but not former (1.017 [0.792-1.306]) smokers were less likely to have HIP than non-smokers. Furthermore, 1 h and 2 h oral plasma glucose test values were lower in current smokers than in non-smokers ( < 0.01). To exclude potential selection bias, we compared risk factors for HIP and HIP-related adverse pregnancy outcomes in current smokers according to HIP screening status. Compared with screened current smokers (n = 934), their unscreened counterparts (n = 300) were younger, less frequently employed, and more likely to be of non-European origin. Moreover, infant birthweight was lower in this group, and preterm deliveries and perinatal deaths were more likely (all < 0.01). Smoking during pregnancy was independently associated with lower HIP prevalence. The low HIP screening rate in current smokers did not explain this finding.
我们旨在探讨孕期吸烟与高血糖（HIP）之间仍存在争议的关联。对2012年至2018年在让·韦迪耶大学医院分娩的15801名女性进行了一项多民族前瞻性研究。其中，13943名（88.2%）为非吸烟者，624名（4.5%）为既往吸烟者，1234名（7.8%）为当前吸烟者。对整个样本（国际糖尿病和妊娠研究组/世界卫生组织标准）进行了普遍的HIP筛查。共有13958名女性接受了HIP筛查。非吸烟者、既往吸烟者和当前吸烟者的筛查接受率不同（分别为89.5%、88.3%和75.7%，<0.0001）。这些组中的HIP患病率分别为19.9%、15.4%和12.3%（<0.0001）。在调整年龄、体重指数、糖尿病家族史、HIP病史、巨大儿病史和种族后，当前吸烟者（比值比0.790[95%置信区间0.636 - 0.981]，<0.05）而非既往吸烟者（1.017[0.792 - 1.306]）患HIP的可能性低于非吸烟者。此外，当前吸烟者的1小时和2小时口服血浆葡萄糖测试值低于非吸烟者（<0.01）。为排除潜在的选择偏倚，我们根据HIP筛查状态比较了当前吸烟者中HIP及与HIP相关的不良妊娠结局的危险因素。与接受筛查的当前吸烟者（n = 934）相比，未接受筛查的对应者（n = 300）更年轻，就业频率更低，且更可能是非欧洲裔。此外，该组婴儿出生体重较低，早产和围产期死亡的可能性更大（均<0.01）。孕期吸烟与较低的HIP患病率独立相关。当前吸烟者中较低的HIP筛查率并不能解释这一发现。
