Role of Maternal Smokeless Tobacco Ingestion During Pregnancy in Delivery of Preterm Babies

Abstract

Background:Smokeless tobacco is an established cause of adverse pregnancy outcome. Preterm deliveries are quite high(14%) in our country and approximately 39% women in Bangladesh use smokeless tobacco (ST).Objective: To determine the outcome of maternal smokeless tobacco ingestion during pregnancy in delivery of preterm babies.Methods: A retrospective case control study was carried out in the department of Pediatrics & department of Obstetrics and Gynecology in Dhaka Medical College Hospital between July 2010 to June 2011. Immediately after admission, detailed history of the newborn baby & mother was taken. A total of 100 cases (preterm babies) and 100 suitably matched controls (sick term neonates) were enrolled. Every case satisfying the selection criteria (inclusion & exclusion criteria) was enrolled in the study. The mother was asked whether she used to use smokeless tobacco (jorda, shada or gul) during pregnancy and about frequency and duration of ingestion of ST.Results: Baseline characteristics of cases and controls were comparable. ST user mothers of preterm babies used ST about 5 times a day. Maternal smokeless tobacco (ST) use during pregnancy was significantly associated (46%) with the delivery of preterm babies (p<0.001) and carries a risk of 2.7 times than that of non ST users.Conclusion: Maternal ST use ?5 times a day during pregnancy increases 2.7 folds risk of delivery of preterm babies than that of non-ingested.Bangladesh J Child Health 2016; VOL 40 (3) :135-138

Study of Tobacco Smoke and Pregnancy Outcome

“…14 Cotinin levels as an indicator of cigarette exposure are also strongly related to preterm birth 4 The danger of non-smoking tobacco is also seen in the research of Munmun et al Which shows that non-smoking tobacco (chewed and swallowed) increases the risk of preterm birth. 15 There are four mechanisms proposed by Goldstein et al explain relationship between smoking and preterm birth: (a) Decreased maternal appetite caused by smoking leading to a decrease in nutrition for the fetus, (b) vasoconstriction caused by smoking results in decreased blood supply to the fetus, reduced fetal nutritional supply and slowing the release of catabolism results, (c) cigarettes may have a direct effect of toxins on the fetus and (d) increase in fetal CO levels causes reduced oxygen transport capacity and teratogenic properties. 11,16 Prostagladin has been known to trigger labor.…”

Tobacco Smoke and Pregnancy Outcome: Literature Review

“…Abnormalities in these genes make mothers more vulnerable to exposure to hazardous substances such as cigarette smoke. 14 Cotinin levels as anindicator of cigarette exposure are also strongly related to preterm birth. 4 The danger of non-smoking tobacco is also seen in the research of Munmun et al Which shows that non-smoking tobacco (chewed and swallowed) increases the risk of preterm birth.…”