Effect of Maternal Smokeless Tobacco use during Pregnancy on Neonatal Outcome- A Hospital-Based Study

Abstract

Introduction: Outcomes that are related to maternal smokeless tobacco (ST) were considerably assessed over the past 50 years with resultant health issues. About 28% of Bengali women have been seen using ST. Some significant health consequences of smoking during pregnancy as, continuous abortion, stillbirth, preterm delivery, preeclampsia, low birth weight babies, and intrauterine growth retardation. Aim of the study: To investigate the influence of use ST during pregnancy on aspects of neonatal outcome like LBW & preterm birth. Methods: A comparative cross sectional study, conducted in the Department of Paediatrics and Department of Gynecology & Obstetrics, Dhaka Medical College Hospital, Dhaka from January 2009 to December 2010. A total of 340 mother-neonate pairs were included in the study and among them,170 mothers using ST for years and heir recently delivered newborn infants ( mother-neonate pairs) were enrolled as ‘cases’ by purposive sampling, and another 170 mother-newborn pairs matched with histories of not using smokeless tobacco or smoke were enrolled as controls. Detailed history of each mother about the antenatal period was taken and through physical examination of the mother was done immediately. Each neoborn was assessed for birth weight and gestational age. Birth weight was weighted in gram using baby scale. Gestional age was determined by LRMP method and also by New Ballard Scoring System. Result: Most of the mothers in this study used shada, followed by jorda, shada+jorda and gul. Smokeless tobacco (ST) used by mothers during pregnancy had a significant association with the delivery of LBW baby (P <0.001) and carries a risk of having delivery of LBW baby 3.7 times higher compared to nonusers of smokeless tobacco. Preterm delivery((P <0.001 )was significantly associated with use of smokeless tobacco by mothers in the study group in comparison to the control group and carries a risk of having preterm delivery 3.1 times more than nonusers. ...........