American Journal of Obstetrics & Gynecology
Volume 203, Issue 4 , Pages 334.e1-334.e8, October 2010

The risk of adverse pregnancy outcomes is increased in preeclamptic women who smoke compared with nonpreeclamptic women who do not smoke

  • Elizabeth C. Miller, BScH

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • Queen's University School of Medicine, Kingston, ON, Canada
    • Corresponding Author InformationReprints: Elizabeth Miller, BScH, Departments of Obstetrics and Gynecology, Perinatology and Clinical Epidemiology, The Ottawa Hospital, General Campus, 501 Smyth Rd., Ottawa, ON, Canada, K1H 8L6
    • ,
  • Huiling Cao, MSc

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • ,
  • Shi Wu Wen, PhD, MB

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
    • ,
  • Qiuying Yang, PhD, MD

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
    • ,
  • Julie Lafleche, BSc

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • ,
  • Mark Walker, MSc, MD

      Affiliations

    • OMNI Research Group, Clinical Epidemiology Unit, Ottawa Health Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
    • Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
    • Ontario Perinatal Surveillance System, Ottawa, ON, Canada

Received 13 July 2009; received in revised form 26 February 2010; accepted 11 May 2010. published online 28 June 2010.

Objective

Maternal smoking and preeclampsia independently increase the risk of adverse pregnancy outcomes; however, smoking decreases the risk of preeclampsia. We sought to estimate the risk of adverse pregnancy outcomes among preeclamptic women who smoke and hypothesized that this risk would be increased, compared with nonpreeclamptic women who smoke or preeclamptic women who do not smoke.

Study Design

With the use of the Niday Perinatal Database and multiple logistic regressions, we estimated the risk of adverse pregnancy outcomes in nonpreeclamptic women who smoke, preeclamptic women who do not smoke, and preeclamptic women who smoke in relation to nonpreeclamptic women who do not smoke.

Results

The incidence of adverse pregnancy outcomes was more than twice as high among preeclamptic women who smoke as among nonpreeclamptic women who do not smoke. The following data were observed: small-for-gestational-age infant (odds ratio [OR], 3.40; 95% CI, 2.27–4.89), preterm birth (OR, 5.77; 95% CI, 4.50–7.35), very preterm birth (OR, 5.44; 95% CI, 3.51–8.11), abruption (OR, 6.16; 95% CI, 3.05–11.01), Apgar <4 at 5 minutes (OR, 3.11; 95% CI, 1.48–5.72), and stillbirth (OR, 3.39; 95% CI, 1.33–6.99).

Conclusion

Smoking decreases the risk of preeclampsia, but smokers with preeclampsia have an increased risk for adverse pregnancy outcomes.

Key words: adverse pregnancy outcome, preeclampsia, smoking

 

 Supported by the Ottawa Health Research Institute.

 Cite this article as: Miller EC, Cao H, Wen SW, et al. The risk of adverse pregnancy outcomes is increased in preeclamptic women who smoke compared with nonpreeclamptic women who do not smoke. Am J Obstet Gynecol 2010;203:334.e1-8.

PII: S0002-9378(10)00607-1

doi:10.1016/j.ajog.2010.05.020

American Journal of Obstetrics & Gynecology
Volume 203, Issue 4 , Pages 334.e1-334.e8, October 2010

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