Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome
Background: Small for gestational age (SGA) is a well-known consequence of maternal smoking. Here, we newly examine the magnitude of SGA risk by week of gestational age. Methods: Singleton live births (N = 3,032,928) with recorded birth weight, gestational age (22–44 weeks), and maternal tobacco use...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-06-01
|
| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335520300401 |
| _version_ | 1818859697498750976 |
|---|---|
| author | Steven H. Lamm Hamid Ferdosi Isabella J. Boroje Nana Ama Afari-Dwamena Lu Qian Elisabeth Dissen Dash Ji Li Rusan Chen Manning Feinleib |
| author_facet | Steven H. Lamm Hamid Ferdosi Isabella J. Boroje Nana Ama Afari-Dwamena Lu Qian Elisabeth Dissen Dash Ji Li Rusan Chen Manning Feinleib |
| author_sort | Steven H. Lamm |
| collection | DOAJ |
| description | Background: Small for gestational age (SGA) is a well-known consequence of maternal smoking. Here, we newly examine the magnitude of SGA risk by week of gestational age. Methods: Singleton live births (N = 3,032,928) with recorded birth weight, gestational age (22–44 weeks), and maternal tobacco use (Y/N) were categorized as to SGA (Y/N), based on 10th percentile gender-specific weights-for-age. Results: SGA prevalence among tobacco users (19.5%) and non-users (9.1%) yielded a significant SGA prevalence rate ratio of 2.15 (2.13–2.16) and a significant adjusted odds ratio of 2.36 (2.34–2.38). The tobacco non-users’ rate was steadily near 9% across the week 22–44 gestational age range. The tobacco users’ rate was steady until week 33 when it rose monotonically through week 37 to about 20% at week 38 and remained high. This pattern for SGA by gestational week was similar for prevalence rates and adjusted ORs. Tobacco use only through week 33 was not seen to be an SGA risk factor. The magnitude of tobacco use as an SGA risk factor for late third trimester births increased during the period of preterm birth and became fully evident with a two-fold risk for full term infants. Conclusion: We newly report the temporal pattern of tobacco-related SGA by week of gestational age. Tobacco-related SGA was only seen for late third trimester births – increasing during weeks 33–37 with a doubling during weeks 38–44. This pattern, informative for issues of mechanism, highlights the potential benefit of extending tobacco cessation programs through the third trimester of pregnancy. |
| first_indexed | 2024-12-19T09:16:18Z |
| format | Article |
| id | doaj.art-56d73e904cc14a3c9f9e804315044122 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-19T09:16:18Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-56d73e904cc14a3c9f9e8043150441222022-12-21T20:28:05ZengElsevierPreventive Medicine Reports2211-33552020-06-0118Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcomeSteven H. Lamm0Hamid Ferdosi1Isabella J. Boroje2Nana Ama Afari-Dwamena3Lu Qian4Elisabeth Dissen Dash5Ji Li6Rusan Chen7Manning Feinleib8Center for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USA; Department of Health Policy and Management, Johns Hopkins University-Bloomberg School of Public Health, Baltimore, MD, USA; Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA; Corresponding author at: 3201 Idaho Ave NW, Washington DC 20016, USA.Center for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USA; Milken Institute School of Public Health, The George Washington University, Washington, DC, USACenter for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USA; Milken Institute School of Public Health, The George Washington University, Washington, DC, USACenter for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USACenter for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USA; Department of Mathematics and Statistics, American University, Washington, DC, USACenter for Epidemiology and Maternal and Child Health, Consultants in Epidemiology and Occupational Health (CEOH), Washington, DC, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USACenters for New Designs in Learning and Scholarships, Georgetown University, Washington, DC, USADepartment of Epidemiology, Johns Hopkins University-Bloomberg School of Public Health, Baltimore, MD, USABackground: Small for gestational age (SGA) is a well-known consequence of maternal smoking. Here, we newly examine the magnitude of SGA risk by week of gestational age. Methods: Singleton live births (N = 3,032,928) with recorded birth weight, gestational age (22–44 weeks), and maternal tobacco use (Y/N) were categorized as to SGA (Y/N), based on 10th percentile gender-specific weights-for-age. Results: SGA prevalence among tobacco users (19.5%) and non-users (9.1%) yielded a significant SGA prevalence rate ratio of 2.15 (2.13–2.16) and a significant adjusted odds ratio of 2.36 (2.34–2.38). The tobacco non-users’ rate was steadily near 9% across the week 22–44 gestational age range. The tobacco users’ rate was steady until week 33 when it rose monotonically through week 37 to about 20% at week 38 and remained high. This pattern for SGA by gestational week was similar for prevalence rates and adjusted ORs. Tobacco use only through week 33 was not seen to be an SGA risk factor. The magnitude of tobacco use as an SGA risk factor for late third trimester births increased during the period of preterm birth and became fully evident with a two-fold risk for full term infants. Conclusion: We newly report the temporal pattern of tobacco-related SGA by week of gestational age. Tobacco-related SGA was only seen for late third trimester births – increasing during weeks 33–37 with a doubling during weeks 38–44. This pattern, informative for issues of mechanism, highlights the potential benefit of extending tobacco cessation programs through the third trimester of pregnancy.http://www.sciencedirect.com/science/article/pii/S2211335520300401Small-for-gestational age (SGA)Maternal tobacco exposureThird-trimester |
| spellingShingle | Steven H. Lamm Hamid Ferdosi Isabella J. Boroje Nana Ama Afari-Dwamena Lu Qian Elisabeth Dissen Dash Ji Li Rusan Chen Manning Feinleib Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome Preventive Medicine Reports Small-for-gestational age (SGA) Maternal tobacco exposure Third-trimester |
| title | Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome |
| title_full | Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome |
| title_fullStr | Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome |
| title_full_unstemmed | Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome |
| title_short | Maternal tobacco use: A third-trimester risk factor for small-for-gestational-age pregnancy outcome |
| title_sort | maternal tobacco use a third trimester risk factor for small for gestational age pregnancy outcome |
| topic | Small-for-gestational age (SGA) Maternal tobacco exposure Third-trimester |
| url | http://www.sciencedirect.com/science/article/pii/S2211335520300401 |
| work_keys_str_mv | AT stevenhlamm maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT hamidferdosi maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT isabellajboroje maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT nanaamaafaridwamena maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT luqian maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT elisabethdissendash maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT jili maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT rusanchen maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome AT manningfeinleib maternaltobaccouseathirdtrimesterriskfactorforsmallforgestationalagepregnancyoutcome |