Cigarette smoking during pregnancy and risk of preeclampsia: A systematic review

Conde-Agudelo, Agustín; Althabe, Fernando; Belizán, José M.; Kafury-Goeta, Ana C.

doi:10.1016/s0002-9378(99)70341-8

Cited by 298 publications

(221 citation statements)

References 62 publications

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“…Despite this, smoking did not prevent the serious co-morbidities associated with GDM; however, the study was not powered for these less frequent outcomes. Although tobacco use has some protective effect for adverse pregnancy outcome, 18 we do not recommend tobacco use to decrease the frequency of LGA infants in patients with GDM. The impact of smoking during pregnancy identified in this and other studies do not justify its use.…”

Section: Discussionmentioning

confidence: 90%

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The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes

Contreras,

Kominiarek,

Zollinger

2009

J Perinatol

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Objective: To determine the effects of tobacco use on perinatal outcomes among patients with gestational diabetes (GDM).Study Design: This was a retrospective cohort study of singleton pregnancies with GDM and live births from 2003 to 2006. The primary outcome, large for gestational age (LGA) infants, was compared between smoking and nonsmoking groups. Secondary outcomes included cesarean deliveries, shoulder dystocia, birth trauma, peripartum complications, macrosomia, 5-min Apgar score p3, birth defects, and neonatal intensive care unit (NICU) admissions. w 2 and Student t-tests compared the two groups; a P-value <0.05 was statistically significant and odds ratios (OR) were reported with 95% confidence intervals (CI). A multivariate logistic regression analysis controlled for variables known to affect outcomes in GDM. Result:We identified 915 patients with GDM, of which 130 (14.2%) smoked during pregnancy. Women who smoked during pregnancy were less likely to have LGA infants (22.4 vs 31.2%; OR, 0.61; 95% CI, 0.39 to 0.95). In a logistic regression analysis, the inverse relationship between smoking and LGA persisted (OR, 0.59; 95% CI, 0.36 to 0.97) after controlling for maternal age, multiparity, ethnicity, weight status before pregnancy, weight gain during pregnancy, and male gender. Preterm labor, preeclampsia, Cesareans, shoulder dystocia, and birth trauma were similar in both groups. PPROM was more likely to occur in nonsmokers (0 vs 4%, P ¼ 0.03), but postpartum hemorrhage was more common among smokers (OR, 2.3; 95% CI, 1.02 to 5.31). Macrosomia, low 5-min Apgar score, birth defects, and NICU admissions were similar between the groups. Conclusion:Patients with GDM who smoke during pregnancy were 40% less likely to have LGA infants. However, smoking was not protective of other common morbidities associated with GDM.

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Section: Discussionmentioning

confidence: 90%

“…18 In contrast, GDM increases the risk for preeclampsia. As the occurrence of preeclampsia was similar between smokers and nonsmokers in our study and similar to that of the general population (5 to 8%), it is possible that GDM and other factors superseded the 'protective' effect of smoking on preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes

Contreras,

Kominiarek,

Zollinger

2009

J Perinatol

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“…One factor that has been consistently found to be associated with lower risk of pre-eclampsia is smoking during pregnancy (12)(13)(14)(15)(16). The same consistency has not been reported for gestational diabetes (17).…”

Section: Introductionmentioning

confidence: 88%

Gestational diabetes and pre-eclampsia: common antecedents?

Wendland

Duncan

Belizán

et al. 2008

Arq Bras Endocrinol Metab

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Objetivo: Avaliar a concordância do padrão de fatores de risco de mulheres que desenvolvem diabetes gestacional e pré-eclâmpsia. Métodos: Estudo de coorte prospectivo em clínicas de atendimento pré-natal do Sistema Único de Saúde de seis capitais do Brasil, 4.766 mulheres grávidas de 20 a 48 anos de idade foram arroladas de maneira consecutiva entre a 20º e 28º semanas de gestação. O hábito de fumar e os fatores de risco tradicionais para pré-eclâmp-sia e diabetes gestacional foram obtidos por entrevista no arrolamento. diabetes gestacional foi diagnosticada usando um teste oral de tolerância a glicose com 75 g e pré-eclâmpsia por meio de revisão de prontuário. Resultados: diabetes gestacional e pré-eclâmpsia são associadas com idade (rc 2,07; 95% Ic 1,65-2,23 e rc 1,55; 95% Ic 1,08-2,23, respectivamente), índice de massa corporal pré-gestacional (rc 1,62; 95% Ic 1,40-3,53 e rc 1,83; 95% Ic 1,52-4,80, respectivamente) e ganho de peso precocemente durante a gestação (rc 1,28; 95% Ic 1,12-1,47 e rc 1,27; 95% Ic 1,06-1,52, respectivamente).

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“…Conversely, increased gene expression of Hmox was shown to decrease circulating levels of sFlt-1 (29). Interestingly, CO levels have been found to be increased in smokers, which may explain the smoking paradox, because smoking seems to confer a protection against preeclampsia (29)(30)(31)(32). Indeed, lower levels of CO have been shown in the exhaled breath of patients with preeclampsia and gestational hypertension (33,34),…”

Section: Heme Oxygenase Pathwaymentioning

confidence: 99%

Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines

Phipps

Prasanna

Brima

et al. 2016

CJASN

496

328

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Preeclampsia is becoming an increasingly common diagnosis in the developed world and remains a high cause of maternal and fetal morbidity and mortality in the developing world. Delay in childbearing in the developed world feeds into the risk factors associated with preeclampsia, which include older maternal age, obesity, and/or vascular diseases. Inadequate prenatal care partially explains the persistent high prevalence in the developing world. In this review, we begin by presenting the most recent concepts in the pathogenesis of preeclampsia. Upstream triggers of the well described angiogenic pathways, such as the heme oxygenase and hydrogen sulfide pathways, as well as the roles of autoantibodies, misfolded proteins, nitric oxide, and oxidative stress will be described. We also detail updated definitions, classification schema, and treatment targets of hypertensive disorders of pregnancy put forth by obstetric and hypertensive societies throughout the world. The shift has been made to view preeclampsia as a systemic disease with widespread endothelial damage and the potential to affect future cardiovascular diseases rather than a selflimited occurrence. At the very least, we now know that preeclampsia does not end with delivery of the placenta. We conclude by summarizing the latest strategies for prevention and treatment of preeclampsia. A better understanding of this entity will help in the care of at-risk women before delivery and for decades after.

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Cigarette smoking during pregnancy and risk of preeclampsia: A systematic review

Cited by 298 publications

References 62 publications

The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes

The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes

Gestational diabetes and pre-eclampsia: common antecedents?

Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines

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