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The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort.
- Source :
-
Australian & New Zealand Journal of Obstetrics & Gynaecology . Jun2019, Vol. 59 Issue 3, p356-361. 6p. 3 Charts. - Publication Year :
- 2019
-
Abstract
- Background: Maternal smoking is associated with a number of adverse outcomes with a dose‐dependent increase in risk. The aim of this study was to evaluate the obstetric and perinatal outcomes in women who smoked during pregnancy. Methods: This was a retrospective cohort study of women who smoked during pregnancy and birthed at a major perinatal centre in Australia between January 2000 and April 2017. The study cohort was compared to a cohort of women who did not smoke in pregnancy. Smoking status was ascertained on history and included all types of smoking. Demographic characteristics and obstetric, intrapartum and perinatal outcomes were compared between the two groups. Results: The study cohort included 20 477 (14.6%) women who smoked during pregnancy and 119 396 controls. Women who smoked tended to be younger, of higher body mass index (BMI), Caucasian and Indigenous ethnicity. Smokers were less likely to be nulliparous, but more likely to be hypertensive and have a lower socioeconomic status compared to non‐smokers. Women who smoked were more likely to have a caesarean section for non‐reassuring fetal status (adjusted odds ratio (aOR) 1.16, 95%CI 1.07–1.26, P < 0.001). The infants of women who smoked were more likely to be born preterm, have a lower median birth weight and birth weights <10th (aOR 1.76, 95%CI 1.66–1.86, P < 0.001) and <5th centile (aOR 2.00, 95%CI 1.86–2.16, P < 0.001). Neonatal outcomes in the smoking cohort were worse with an increase in neonatal intensive care unit admission (aOR 1.34, 95%CI 1.27–1.43, P < 0.001), severe acidosis (aOR 1.41, 95%CI 1.27–1.43, P < 0.001) and a composite of severe neonatal outcomes (18.0% vs 12.0%, aOR 1.35, 95%CI 1.28–1.43, P < 0.001). Conclusion: Women who smoke in pregnancy have worse obstetric and perinatal outcomes compared to controls and should be managed as high risk. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ACIDOSIS
*APGAR score
*ABORIGINAL Australians
*LOW birth weight
*CESAREAN section
*CHI-squared test
*COMPARATIVE studies
*CONFIDENCE intervals
*STATISTICAL correlation
*DELIVERY (Obstetrics)
*FISHER exact test
*HOSPITALS
*HOSPITAL admission & discharge
*PREMATURE infants
*LONGITUDINAL method
*EVALUATION of medical care
*NEONATAL intensive care
*PATIENTS
*PERINATAL death
*PREGNANCY
*PREGNANCY complications
*SMOKING
*STATISTICS
*T-test (Statistics)
*VAGINA
*WHITE people
*PSYCHOLOGY of women
*MULTIPLE regression analysis
*SOCIOECONOMIC factors
*BODY mass index
*NEONATAL intensive care units
*RETROSPECTIVE studies
*DATA analysis software
*DESCRIPTIVE statistics
*TERTIARY care
*ODDS ratio
*MANN Whitney U Test
*EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00048666
- Volume :
- 59
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Australian & New Zealand Journal of Obstetrics & Gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 136838906
- Full Text :
- https://doi.org/10.1111/ajo.12849