The Human Cost of Tobacco Chewing Among Pregnant Women in India: A Systematic Review and Meta-analysis

Abstract

123 adjusted for smoking with or without adjustment for other factors and duplicate data. Qualitative synthesis was followed by meta-analysis. Attributable burden was estimated using the population attributable fraction method. Main Results Pooled odds ratio was significant for all three outcomes: low birth weight (1.88, 95 % CI 1.38, 2.54), preterm birth (1.39: 1.01, 1.91) and stillbirth (2.85: 1.62, 5.01). We found that 0.87 million low birth weight babies, 0.19 million preterm births and 0.12 million stillbirths occurring annually in India could be attributed to maternal SLT use. Conclusion There was a suggestive evidence of SLT use associated with adverse pregnancy outcomes among women in India. Further studies in this field are required to generate more conclusive evidence.

Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators to Quitting

“…Development and birth defects: Foeti of mothers who smoked during pregnancy were recorded to have reduced foetal measurements including head size, femur length, foetal weight and transcerebellar diameter [34,35,37]. Exposure to tobacco during pregnancy has consistently been reported to result in low birth weight (LBW) [42][43][44][45][46]. Smoking tobacco during pregnancy can increase the chances of LBW by 200% (OR = 2.00, 95% CI: 1.77-2.26) [33].…”

“…Eleven reviews (Table 3) described the health effects of second-hand smoke exposure during pregnancy [19,26,36,42,45,[48][49][50][51][52][53], three reviews ( Table 3) described health effects of using smokeless tobacco during pregnancy [43,44,54], while two reviews (Table 3) were about health outcomes of water pipe (shisha) use during pregnancy [46,55]. Association between postnatal maternal smoking and wheezing in the past 12 months had an effect size of 1.21 (95% CI: 1.13-1.31; I 2 = 47.0%, p = 0.067).…”

“…Waterpipe and smokeless tobacco use: Waterpipe smoking by pregnant women was associated with LBW, low Apgar score, pulmonary complications at birth, and infant mortality [46,55]. Smokeless tobacco (e.g., chewed or oral snuff) delivers high levels of nicotine that may cause dependence, and in pregnancy increased rates of stillbirth, preterm birth, small for gestational age, LBW, and altered male to female live birth ratio [43,44,54]. Suliankatchi (2016) found that women who used smokeless tobacco during pregnancy were almost at double the risk of giving birth to babies with LBW (OR = 1.88, 95 % CI 1.38-2.54) and were at a significantly greater risk of birthing babies who were preterm (OR = 1.39, 95 % CI 1.01, 1.91) or were stillborn (OR = 2.85.…”

“…Suliankatchi (2016) found that women who used smokeless tobacco during pregnancy were almost at double the risk of giving birth to babies with LBW (OR = 1.88, 95 % CI 1.38-2.54) and were at a significantly greater risk of birthing babies who were preterm (OR = 1.39, 95 % CI 1.01, 1.91) or were stillborn (OR = 2.85. 95 % CI 1.62-5.01) [43].…”

Implementation of Article 20 of the World Health Organization Framework Convention on Tobacco Control

“…Subnational estimates were defined if this sample was drawn from one such geographic region of the country. ii Data on health impacts of SLT use (morbidity and mortality) were obtained from published cohort and case-control studies 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 . iii Data on economics of SLT control were obtained from two sources: (a) Comparable tax data on SLT products obtained from the WHO Global Tobacco Epidemic Reports of 2015 and 2017 8 9 .…”