Misra D P, Kiely J L
Division of Epidemiology, Columbia University School of Public Health, New York, NY, USA.
Early Hum Dev. 1995 Jan 30;40(2):95-107. doi: 10.1016/0378-3782(94)01593-E.
Data from the 1988 National Maternal and Infant Health Survey were used to examine the effect of smoking on the risk of gestational hypertension (GH). GH was defined as the occurrence of two consecutive diastolic blood pressure readings of at least 90 mmHg after the 20th week of gestation in the absence of proteinuria in subjects normotensive prior to pregnancy. One-hundred ten subjects with gestational hypertension were compared with 4371 subjects free of all hypertensive disorders. Smoking during pregnancy was associated with a reduction in risk of GH overall (Odds Ratio (95% CI) = 0.18 (0.07-0.43)) and within each race and parity subgroup. When the protective effect of smoking was examined by race, black subjects appeared to benefit less from smoking compared with whites but the weaker effect in blacks was attributable to less smoking by blacks. Parous subjects experienced a larger reduction in the risk of GH associated with smoking than nulliparous subjects and this persisted at each dose level of smoking. Neither the protective effect of smoking nor the difference by parity appeared to be due to confounding by race, age, weight gain, alcohol use or marijuana use (adjusted OR (95% CI): nulliparous 0.28 (0.09-0.94) vs. parous 0.10 (0.03-0.30)).
1988年全国母婴健康调查的数据被用于研究吸烟对妊娠期高血压（GH）风险的影响。妊娠期高血压被定义为在妊娠20周后，既往血压正常且无蛋白尿的受试者连续两次舒张压读数至少为90mmHg。将110名患有妊娠期高血压的受试者与4371名无任何高血压疾病的受试者进行比较。孕期吸烟与总体上GH风险的降低相关（优势比（95%置信区间）=0.18（0.07 - 0.43）），在每个种族和产次亚组中均如此。当按种族检查吸烟的保护作用时，与白人相比，黑人似乎从吸烟中获益较少，但黑人中较弱的作用归因于黑人吸烟较少。经产妇与初产妇相比，吸烟相关的GH风险降低幅度更大，且在每个吸烟剂量水平下均如此。吸烟的保护作用以及产次差异似乎都不是由种族、年龄、体重增加、饮酒或使用大麻导致的混杂因素引起的（调整后的优势比（95%置信区间）：初产妇0.28（0.09 - 0.94）与经产妇0.10（0.03 - 0.30））。
