Associations between late and moderately preterm birth and smoking, alcohol, drug use and diet: a population-based case–cohort study

Abstract

ObjectiveThis study explores the associations between lifestyle factors and late and moderate preterm birth (LMPT: 32+0–36+6 weeks' gestation), a relatively under-researched group.Study designA population-based case–cohort study was undertaken involving 922 LMPT and 965 term (37+ weeks' gestation) singleton live and stillbirths born between 1 September 2009 and 31 December 2010 to women residing in Leicestershire and Nottinghamshire, UK. Poisson multivariable regression models were fitted to estimate relative risks (RR) of LMPT birth associated with maternal smoking, alcohol and recreational drug use, and diet.ResultsWomen who smoked during pregnancy were at 38% increased risk of LMPT birth compared with non-smokers (RR 1.38, 95% CI (1.04 to 1.84)). Low consumption of fruit and vegetables was associated with a 31% increased risk compared with those who reported eating higher consumption levels (RR 1.31 (1.03 to 1.66)). Women who did not have any aspects of a Mediterranean diet were nearly twice as likely to deliver LMPT compared with those whose diet included more Mediterranean characteristics (RR 1.81 (1.04 to 3.14)). Women who smoked and consumed low levels of fruit and vegetables (5% of women) were at particularly high risk (RR=1.81 (1.29 to 2.55)). There was no significant effect of alcohol or recreational drug use on LMPT birth.ConclusionsSmoking and poor diet during pregnancy, factors that strongly impact on very preterm birth, are also important at later gestations and experienced together are associated with an elevated rate of risk. Our findings suggest early cessation of smoking during pregnancy may be an effective strategy to reduce LMPT births.

The Relationships of Health Behaviour and Psychological Characteristics with Spontaneous Preterm Birth in Nulliparous Women

“…Although other studies have suggested that diets containing high amounts of certain fruits and vegetables can reduce the risk for preterm birth (Myhre et al 2013; Smith et al 2015), our study showed that not consuming fruit daily only bordered in significance of being related to spontaneous birth, and not consuming vegetables daily showed no relationship at all. With the exception of alcohol and folic acid, all of the odds ratios of the more suboptimal health behaviour and psychological characteristics pointed in the direction of an increased risk for spontaneous preterm birth, although none of the odds were very high and none of the relationships significant.…”

Term and preterm birth effects of the nutritional status and habits in pregnancy

“…[21] Another study conducted on 922 premature and 965 late birth mothers found that 38% of premature births were in females who smoked during pregnancy. [22] In this study, 21.7% of preterm delivery mothers quit smoking during gestation, 11.7% were occasional smokers, and 3.3% were smokers during pregnancy; 93.3% of term delivery mothers did not smoke at all. Regarding smoke exposure without smoking, it was found that preterm delivery mothers were generally exposed to cigarette smoke by their husband (70.7%), whereas 33.3% of term delivery mothers were exposed to cigarette smoke from outside (p<0.05).…”

Induction of the apoptotic pathway by oxidative stress in spontaneous preterm birth: Single nucleotide polymorphisms, maternal lifestyle factors and health status

“…Maternal lifestyle (14) and health status, including diseases with onset prior to or during pregnancy (15), may influence oxidative stress and affect the apoptotic pathway leading to at-term birth or sPTB, both of which also appear consequent to a mechanism involving genetic and non-genetic factors, which may modulate the oxidative stress-induced apoptosis.…”