The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort

Li, Raymond; Lodge, J. R.; Flatley, Christopher; Kumar, Sailesh

doi:10.1111/ajo.12849

Cited by 19 publications

(15 citation statements)

References 21 publications

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“…The rate of NICU admission was similar between the study groups. Similar results were shown by Kharkova and colleagues (2017) [18], though another study found a significant increase in NICU admission in the smoking cohort [20]. Thus, we cannot accept smoking as the only factor that affects the Apgar score and the need for NICU admission [35].…”

Section: Discussionsupporting

confidence: 73%

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Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country

Hamadneh

2021

Annals of Global Health

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Background: Smoking is one of the modifiable risk factors for adverse maternal and neonatal outcomes and is associated with low birth weight, preterm birth, respiratory, antepartum and intrapartum stillbirth, and perinatal death as well as long-term morbidity in offspring and sudden unexpected infant death. The rate of smoking in low-and middleincome countries is still relevantly high, and Jordan is no exception.Objective: To investigate the effect of active and passive smoking during pregnancy on adverse pregnancy outcomes. MethodsThe case-control study was conducted in Jordan in June 2020. Healthy women with full-term singleton pregnancy (n = 180) were interviewed and stratified into three groups: Group I, active smokers; Group II, passive smokers; and Group III, nonsmokers. The study variables included demographic data, current pregnancy history, cotinine level of mothers and newborns, and perinatal outcomes. Statistical analysis was performed using the application package IBM SPSS 25. Various algorithms of statistical analysis were used depending on the type of distribution of feature and data quality. The threshold for statistical significance was set at p < 0.05. Results:Active smokers had significantly lower gestational age at delivery compared to passive and nonsmoking women (p = 0.038 and p = 0.003, respectively). Neonates from active smoking mothers had significantly lower birth weight compared to neonates from passive and nonsmoking women (p = 0.016 and p = 0.019, respectively), significantly lower head and chest circumferences compared to babies from passive smokers (p < 0.001 and p = 0.036, respectively), and significantly lower first-minute Apgar score compared to those from nonsmoking women (p = 0.023). The urine cotinine level was significantly higher in both active and passive smoking women (both p < 0.01), and it was significantly higher in newborns who had been exposed to smoking in utero despite maternal active or passive smoking status (both p < 0.001). There was a weak negative correlation between urine cotinine level and birth weight: r = -0.14 for maternal cotinine level and r = -0.15 for neonate cotinine level.

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Section: Discussionsupporting

confidence: 73%

“…According to Li and colleagues (2019), smoking women were more likely to have a caesarean section for nonreassuring fetal status [20]. However, in our study, there were no differences in the mode of delivery between women despite their smoking status.…”

Section: Discussioncontrasting

confidence: 72%

Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country

Hamadneh

2021

Annals of Global Health

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“…Maternal smoking, as a confounder, is associated with prematurity, low birth weight and cleft lip, 24,25 characteristics that may be present in the classification of neonatal near miss cases and these are also related to a longer hospitalization. Additionally, smoking itself leads to a higher frequency of neonatal hospitalization, 26 and a higher incidence of pulmonary bronchodysplasia which increases hospitalization length. 27 As the main exposure, our definition of neonatal near miss in this study was validated with the research data (sensitivity: 92.5% and specificity: 97.1%).…”

Section: Discussionmentioning

confidence: 99%

Neonatal near miss and the occurrence of negative outcomes in the first year of life: data from a national survey, Nascer no Brasil (Born in Brazil), 2011-2012

Kale

Fonseca

Silva

2020

Rev. Bras. Saude Mater. Infant.

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Objectives: estimate the strength of association between neonatal near miss and the nega-tive outcomes in the child’s first year of life. Methods: a prospective cohort study on neonatal survivors originating from a national survey “Nascer no Brasil (Born in Brazil), 2011-2012.” Main exposure: neonatal near miss (NNM). Negative outcomes: breastfeeding, hospitalization, and post neonatal death (tele-phone interview). For each outcome, the odds ratio (OR) were estimated by univariate (p<0.2) and multivariate (p<0.05) logistic regression models. Results: among 15,675 children 3.3% were neonatal near miss. Neonatal near miss was associated, after adjusting, to: weaning (OR=1.8); hospitalization after hospital discharge (OR=2.2); remained hospitalized (OR=65.6) and post neonatal death (OR=52.4) The increased OR after adjusting revealed negative confounding, such as “remained hospitalized since childbirth” (ORcrude=21.1 and ORadjusted=65.6). Conclusions: although neonatal near miss reflects a good quality of health care, avoiding neonatal death, these survivors have higher risk of negative outcomes in the first year of life.

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“…It has been reported that smoking [22,23] and illicit drug use during pregnancy [24,25] are associated with several adverse perinatal outcomes. In Australia, indigenous women have significantly poorer neonatal outcomes attributable to smoking, alcohol and substance misuse, and assault [26].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Increased Risk of Early Severe Neonatal Morbidity in Late Preterm and Early Term Infants

Mengistu

Schreiber

Flatley

et al. 2021

JCM

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Although the risk of neonatal mortality is generally low for late preterm and early term infants, they are still significantly predisposed to severe neonatal morbidity (SNM) despite being born at relatively advanced gestations. In this study, we investigated maternal and intrapartum risk factors for early SNM in late preterm and early term infants. This was a retrospective cohort study of non-anomalous, singleton infants (34+0–38+6 gestational weeks) born at the Mater Mother’s Hospital in Brisbane, Australia from January 2015 to May 2020. Early SNM was defined as a composite of any of the following severe neonatal outcome indicators: admission to neonatal intensive care unit (NICU) in conjunction with an Apgar score <4 at 5 min, severe respiratory distress, severe neonatal acidosis (cord pH < 7.0 or base excess <−12 mmol/L). Multivariable binomial logistic regression analyses using generalized estimating equations (GEE) were used to identify risk factors. Of the total infants born at 34+0–38+6 gestational weeks, 5.7% had at least one component of the composite outcome. For late preterm infants, pre-existing diabetes mellitus, instrumental birth and emergency caesarean birth for non-reassuring fetal status were associated with increased odds for early SNM, whilst for early term infants, pre-existing and gestational diabetes mellitus, antepartum hemorrhage, instrumental, emergency caesarean and elective caesarean birth were significant risk factors. In conclusion, we identified several risk factors contributing to early SNM in late preterm and early term cohort. Our results suggest that predicted probability of early SNM decreased as gestation increased.

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The burden of adverse obstetric and perinatal outcomes from maternal smoking in an Australian cohort

Abstract: Women who smoke in pregnancy have worse obstetric and perinatal outcomes compared to controls and should be managed as high risk.

Cited by 19 publications

References 21 publications

Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country

Active and Passive Maternal Smoking During Pregnancy and Birth Outcomes: A Study From a Developing Country

Neonatal near miss and the occurrence of negative outcomes in the first year of life: data from a national survey, Nascer no Brasil (Born in Brazil), 2011-2012

Factors Associated with Increased Risk of Early Severe Neonatal Morbidity in Late Preterm and Early Term Infants

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