Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
BMC Pregnancy Childbirth. 2024 Oct 4;24(1):646. doi: 10.1186/s12884-024-06863-8.
Snuff is a smokeless source of nicotine that is common in Scandinavia and increasingly used by women of fertile age. Persistent use of snuff during pregnancy has been associated with adverse pregnancy outcomes. Emerging data from the Medical Birth Registry of Norway distinguishes between occasional use and daily use. We provide preliminary estimates of associations between frequency of snuff and gestational length and birth weight.
Data on snuff use during pregnancies delivered in 2020 and 2021 were available for the west and central regions of Norway. Associations of snuff use with gestational length and birth weight at term (39-41 weeks) were estimated using quantile regression at the 25th, the 50th and the 75th percentiles, with adjustments for mother's age, pre-pregnancy weight, and parity. We compared associations with the pregnancy outcomes according to maternal snuff and cigarette use.
12.4% of 18 042 non-smoking women reported daily use of snuff before pregnancy, and 4.6% reported continuing use during pregnancy, with 1.2% still reporting daily use in the last trimester. Women with daily use through the last trimester delivered babies with a median gestational length reduced by 3.4 days (95% CI: -5.0 to -1.7 days) compared with women who never used snuff. The reduction was even stronger at the 25th percentile of gestational age. The median term birth weight was reduced by 44 g (95% CI: -134 to 46 g). These associations were much weaker for women who quit snuff at some point during pregnancy or used snuff only occasionally. Mothers who smoked daily through the last trimester had a median gestational length reduced by 2.1 days (95% CI: -2.7 to -1.4) and a median term birth weight reduced by 294 g (95% CI: -325 to -262) compared with never-smokers.
Daily snuff use through the last trimester reduced the median gestational length by more than three days. Snuff reduced birth weight, but not as much as smoking, suggesting that the predominant effect of smoking on fetal growth is not through nicotine but through the additional toxic chemicals in cigarettes or by reduced oxygen supply to the fetus.
鼻烟是一种无烟的尼古丁来源，在斯堪的纳维亚很常见，越来越多的育龄妇女使用。怀孕期间持续使用鼻烟与不良妊娠结局有关。挪威医学出生登记处的新数据区分了偶尔使用和每天使用。我们提供了鼻烟使用频率与妊娠期和足月出生体重之间关联的初步估计。
2020 年和 2021 年在挪威西部和中部地区分娩的孕妇的鼻烟使用数据可用。使用分位数回归估计了鼻烟使用与妊娠期和足月（39-41 周）出生体重的关系，调整了母亲的年龄、孕前体重和产次。我们比较了根据母亲使用鼻烟和香烟与妊娠结局的关联。
18042 名不吸烟的女性中，12.4%的人在怀孕前每天使用鼻烟，4.6%的人在怀孕期间继续使用，1.2%的人在最后三个月仍每天使用。最后三个月每天使用鼻烟的女性，其妊娠中位数缩短了 3.4 天（95%可信区间：-5.0 至-1.7 天），而从未使用过鼻烟的女性则缩短了 3.4 天。在妊娠年龄的第 25 百分位，这种减少更为明显。足月出生体重降低了 44 克（95%可信区间：-134 至 46 克）。对于那些在怀孕期间的某个时间点停止使用鼻烟或偶尔使用鼻烟的女性，这些关联要弱得多。最后三个月每天吸烟的母亲，其妊娠中位数缩短了 2.1 天（95%可信区间：-2.7 至-1.4），足月出生体重降低了 294 克（95%可信区间：-325 至-262），与从不吸烟的母亲相比。
最后三个月每天使用鼻烟会使妊娠中期缩短三天以上。鼻烟降低了出生体重，但不如吸烟那么多，这表明吸烟对胎儿生长的主要影响不是通过尼古丁，而是通过香烟中的其他有毒化学物质，或通过减少胎儿的氧气供应。
