Effects of Environmental Tobacco Smoke on Perinatal Outcomes: A Retrospective Cohort Study

Crane, Joan; Keough, Montgomery; Murphy, Phil; Burrage, Lorraine; Hutchens, Donna

doi:10.1097/ogx.0b013e31823311a7

Cited by 19 publications

(32 citation statements)

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“…Although this mean reduction (0.2 weeks) is small at an individual level, at a population level this may shift the distribution to the left resulting in a significant burden; further, active maternal smoking only reduced gestation by 0.6 weeks on average and yet more than doubled the rate of preterm birth. The deleterious effect of ETSE on perinatal outcomes is also emphasised by the finding of a strong association with reduced birth weight of a similar magnitude to that previously reported 5,6,16 . Our study shows that ETSE is associated with both shorter gestation and reduced birth weight, but it was not associated with an increased risk of either SGA or PTB.…”

Section: Strengths and Limitationssupporting

confidence: 64%

“…This is most likely mediated by a reduction in the number of women smoking during their pregnancies, but there is emerging evidence that environmental exposure to tobacco smoke, known as passive smoking, may also affect PTB rates. It has been estimated that 11-50% of non-smoking pregnant women are exposed to environmental tobacco smoke 5,7,[15][16][17] and this exposure has been associated with reduced birth weight 5 .…”

Section: Introductionmentioning

confidence: 99%

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Environmental Tobacco Smoke Exposure in Pregnancy is Associated With Earlier Delivery and Reduced Birth Weight

2015

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. AbstractThe association between maternal smoking and preterm birth (PTB) has been known for more than 50 years but the effect of passive smoking is controversial. This retrospective cohort study in Bristol, UK, examines the effect of environmental tobacco smoke exposure (ETSE) on gestational age at delivery, birth weight, PTB and small-for-gestational age (SGA). ETSE was defined by either selfreport or exhaled carbon monoxide (eCO) levels; exposed women were compared with unexposed controls. Two models were used: The first included all women with adjustment for maternal smoking, the second considered non-smokers alone. Both models were further adjusted for maternal age, BMI, parity, ethnicity, employment status, socioeconomic position, asthma, preeclampsia and offspring sex. Logistic regression and likelihood ratio tests were used to test for any association between exposure and the binary outcomes (PTB and SGA), whilst linear regression and F-tests were used to test for associations between exposure and the continuous outcomes. There were 13359 deliveries in 2012-2014, with complete data for 5066 and 4793 women in the selfreported and eCO-measured exposure groups, respectively. Self-reported exposure was associated with earlier delivery (-0.19 weeks; 95% CI: -0.32 to -0.05) and reduced birth weight (-56 g, 95% CI: -97 to -16 g) but no increase in the risk of PTB or SGA. There was no evidence for an association between eCO-measured exposure and any of the outcome measures. This information is important when advising women and their families, and adds further support to continued public health efforts to reduce exposure to tobacco smoke.

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Section: Strengths and Limitationssupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Environmental Tobacco Smoke Exposure in Pregnancy is Associated With Earlier Delivery and Reduced Birth Weight

2015

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“…Table 1 summarises the included studies . An additional 13 studies were identified for LBW [14][15][16][17][18][19][20][21][22][23][24][25] 11 for PTB [16-19, 21, 24, 26-30], five for stillbirth [17,24,[31][32][33], and one for cleft lip [34], beyond those included in previous reviews. Together, the 39 studies represented 223,073 women/infants: 78,948 were included in LBW analyses; 89,831 in PTB analyses; 123,900 in stillbirth analyses; and 7422 in cleft lip analyses (some women were included in multiple analyses).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of maternal secondhand smoke exposure and neonatal outcomes

Parascandola¹,

Klein²,

Bromberg³

2019

jhi

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Objectives: To determine the risk of adverse pregnancy and foetal outcomes among nonsmoking women exposed to secondhand smoke (SHS) while pregnant and compare the quality of studies in middle-and high-income countries (MIC and HIC). Material and methods: To assess the effect of maternal SHS exposure on preterm birth, low birth weight, stillbirth, and orofacial clefts, the authors searched three databases (2004-2015) and applied strict inclusion/exclusion criteria. Crude odds ratios (ORs), adjusted ORs, associated 95% confidence intervals, and raw data were used to estimate pooled ORs using random-effects models. Models were stratified by adjusted/unadjusted data, high study quality vs. low quality, and country income level. Results: The authors identified 39 studies that assessed the effect of maternal SHS exposure on the four outcomes. Of these studies, the 20 conducted in MICs were of lower quality on average than those conducted in HICs. Evidence of a statistically significant effect of SHS exposure was found using adjusted pooled ORs among the high-quality studies for low birth weight (pOR: 1.282 [95% CI: 1.103-1.490]), preterm birth (pOR: 1.290 [95% CI: 1.127-1.476]), and stillbirth (pOR: 1.230 [95% CI: 1.037-1.459]). Using the high-quality adjusted ORs, the effect of SHS exposure in nonsmoking pregnant women on cleft palate with or without cleft lip did not reach significance (pOR: 1.307 [95% CI: 0.893-1.9]). Conclusions: In all analyses, the odds of having negative outcomes were greater among studies conducted in MICs than in HICs. More research is needed in middle-income countries to inform policy and practice.

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“…Preterm Birth  Cigarette smoking (Bottorff et al, 2014)  Cigarette smoking (Koullali et al, 2016)  Exposure to environmental tobacco (Ashford et al, 2010;Crane et al, 2011;Savitz & Murnane, 2010)  Alcohol, cannabis and other illicit drug use (Salas-Wright et al, 2015)  Cannabis use (Prunet et al, 2016)  Sub-optimal nutrition (Bloomfield, 2011)  Inappropriate gestational weight gain (Haggarty et al, 2009;Harper et al, 2011)  Low/high body mass index (Koullali et al, 2016)  Inappropriate gestational weight gain (El Rafei et al, 2016)  Maternal anxiety and/or depression (Siegel & Brandon, 2014)  Maternal anxiety (Liou et al, 2016)  Maternal depression (Accortt et al, 2014)  Stress (Straub et al, 2014)  Intimate partner violence (Edirne et al, 2010;O'Donnell et al, 2009)  Intimate partner violence (Donovan et al, 2016)  'Inadequate' antenatal care (Debiec et al, 2010;Raatikainen et al, 2007)  'Inadequate' antenatal care (Prunet et al, 2016)  Genito-urinary infection (Goyal et al, 2016)  Genito-urinary infection (Sangkomkamhang et al, 2008)…”

Section: Adolescent Pregnancymentioning

confidence: 99%

How optimal caseload midwifery can modify predictors for preterm birth in young women: Integrated findings from a mixed methods study

2016

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the institutional infrastructure and managerial support for caseload midwifery should value and prioritise the philosophical commitments and personal attributes required to optimise the model. Furthermore the location of visits, between appointment access to primary midwife, and back-up system should be organised to optimise the midwife-woman relationship in order to promote the young woman's engagement with maternity care.

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Effects of Environmental Tobacco Smoke on Perinatal Outcomes: A Retrospective Cohort Study

Cited by 19 publications

References 0 publications

Environmental Tobacco Smoke Exposure in Pregnancy is Associated With Earlier Delivery and Reduced Birth Weight

Environmental Tobacco Smoke Exposure in Pregnancy is Associated With Earlier Delivery and Reduced Birth Weight

Systematic review and meta-analysis of maternal secondhand smoke exposure and neonatal outcomes

How optimal caseload midwifery can modify predictors for preterm birth in young women: Integrated findings from a mixed methods study

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