Anemia in pregnant women who use smokeless tobacco

Abstract

A significantly higher mean hemoglobin level in women smokers in comparison to nonsmokers with a generalized rightward shift of the hemoglobin distribution curve has been reported at the population level. Studies on pregnant women, however, have often associated smoking with decreased hemoglobin levels, although not consistently. We examined whether smokeless tobacco use during pregnancy influenced hemoglobin levels in a population-based cohort of 918 pregnant women in Mumbai, India. Mean hemoglobin levels (Hb) were significantly lower in users (10.00 g/dl) compared with nonusers (10.46 g/dl), p<.000. Anemia (Hb<10 g/dl) was significantly associated with smokeless tobacco in the univariate analysis (OR = 1.7, 95% CI 1.2-2.5). There was no change after adjusting odds ratios for potential confounders in multivariate analysis (OR = 1.7, 95% CI 1.2-2.5). The odds ratios for anemia were adjusted for age of mother, education, socioeconomic status, type of residence, lower body mass index, parity, vegetarian or nonvegetarian food habit, and hemodilution during pregnancy. The results suggest that smokeless tobacco use during pregnancy is associated with lower hemoglobin levels, as has often been observed with cigarette smoking. Smokeless tobacco use is widely prevalent among women in Southeast Asia and is gaining popularity across the world as a safe alternative to smoking. Further exploration and clarification of this association is therefore of considerable importance to public health.

Prevalence of anemia and determination of some hematological parameters among pregnant women in Baghdad city

“…The anemic and non-anemic pregnant then were divided according to age into three groups (17-27 , 28- rd group , from these results , the prevalence of anemia is higher in 28-38 years age group. And this is may be due to un healthy nutrition and having the fast food [21]. In the present study 41% of the anemic pregnant ladies were in 1 st trimester, 37% are in 2 nd and 22% in 3 rd trimester, these results were different from other studies in Sweden and Holland [22] .…”

Unveiling the experiences of women of reproductive age with access to iron-rich food and the use of gutka: an exploratory study from a coastal slum of Karachi, Pakistan

“…Substance abuse in the form of chewed or smokeless tobacco may be associated with anemia among MWRA in developing countries, such as Pakistan. (22) Gutka is the most common form of smokeless tobacco that is made of tobacco with areca nut, catechu, slake lime and other ingredients. The ndings from this study have revealed that of nonpregnant MWRA who consumed gutka (i.e., 38% consumers of gutka among the study participants) on a regular basis, many were anemic (results from phase-1 of this study).…”

Smokeless tobacco consumption and stillbirth: Population‐based case–control study in rural Bangladesh

“…Furthermore, exposure to cotinine in the foetuses of smokeless tobacco consumers has been reported , indicating that nicotine and perhaps other toxic substances cross the placental barrier . STC during pregnancy has also been linked with growth restriction , preterm delivery , anaemia and placental morphologic changes . These mechanisms may increase the risk of stillbirth from STC.…”