Influence of Snuff and Smoking Habits in Early Pregnancy on Risks for Stillbirth and Early Neonatal Mortality
Influence of Snuff and Smoking Habits in Early Pregnancy on Risks for Stillbirth and Early Neonatal Mortality
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DOI：
10.1093/ntr/ntt117
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发表时间：
2014-01-01
影响因子：
4.7
通讯作者：
Cnattingius, Sven
中科院分区：
文献类型：
--
作者：
Baba, Sachiko;Wikstrom, Anna-Karin;Cnattingius, Sven
据报道，产前接触瑞典鼻烟（包括尼古丁和磨碎烟草中的其他成分）会增加死产风险，但鼻烟对早期新生儿死亡率的影响尚不清楚。产前吸烟暴露与死产和早期新生儿死亡的风险相关。我们的目的是研究在第一次产前检查前戒烟或戒烟的女性是否会降低风险。在一项针对 1999 年至 2010 年瑞典 851,371 名单胎出生的全国性研究中，我们使用多重逻辑回归模型来研究停止或继续使用鼻烟或吸烟与死产（28 周或之后）和早期新生儿死亡率（出生第一周内死亡）风险之间的关联。妊娠早期不吸烟者、吸鼻烟者和吸烟者死产的风险增加，调整后的比值比 (OR)（95% 置信区间 (CI)）分别为 1.43 (1.021.99) 和 1.59 (1.401.80)。在第一次产前检查前停止使用鼻烟或停止吸烟的女性并没有增加风险。与不吸烟者相比，吸烟者早期新生儿死亡的风险增加（调整后 OR 1.37 [95% CI 1.111.71]）。在怀孕早期停止吸烟和吸鼻烟的女性并没有增加新生儿早期死亡的风险。吸鼻烟和吸烟都会影响死产的风险，停止吸鼻烟或吸烟的女性与不吸烟的女性有相似的死产风险。吸烟而不是吸鼻烟会影响新生儿早期死亡的风险。
Prenatal exposure to Swedish snuff (including nicotine and other components in grinded tobacco) is reported to increase stillbirth risk, but the effect of snuff on early neonatal mortality is unknown. Prenatal smoking exposure is associated with risks for both stillbirth and early neonatal mortality. We aimed to study if women who quit using snuff or quit smoking before first antenatal visit reduce their risks.In a nationwide study of 851,371 singleton births in Sweden from 1999 to 2010, we used multiple logistic regression models to examine associations between cessation or continuation of snuff use or smoking and risks for stillbirth (at 28 weeks or later) and early neonatal mortality (death during the first week of life).Compared with nontobacco users, snuff users and smokers in early pregnancy had increased risks for stillbirths, and adjusted odds ratios (ORs), with 95% confidence intervals (CI), were 1.43 (1.021.99) and 1.59 (1.401.80), respectively. Women who stopped using snuff or stopped smoking before first visit to antenatal care had no increased risks. Compared with nontobacco users, smokers had an increased risk for early neonatal mortality (adjusted OR 1.37 [95% CI 1.111.71]). Women who stopped smoking and snuff users in early pregnancy had no increased risks of early neonatal mortality.Both snuff and smoking influence risk for stillbirth, and women who stop using snuff or smoking have a similar stillbirth risk as nontobacco users. Smoking but not snuff use influences risk for early neonatal mortality.