Tobacco Use During Pregnancy and Preeclampsia Risk

Abstract

Abstract-Preeclampsia is a leading cause of maternal and infant mortality and morbidity worldwide. Both Swedish snuff and cigarette smoke include nicotine, but combustion products accompany only smoking. The aims of this study were to compare the effects of Swedish snuff and cigarette smoking on preeclampsia risk and to estimate whether changes in tobacco habits during pregnancy affect the risk of developing term preeclampsia. We used information from the Swedish Birth Register on all singleton births in Sweden during the years 1999 -2006 (nϭ612 712). Compared with nontobacco users, women who used snuff in early pregnancy had an adjusted odds ratio (OR) for preeclampsia of 1.11 (95% CI: 0.97 to 1.28). The corresponding ORs for light and heavy smokers were 0.66 (95% CI: 0.61 to 0.71) and 0.51 (95% CI: 0.44 to 0.58), respectively, with ORs lower for term than preterm preeclampsia. Compared with nontobacco users, women who smoked in early pregnancy but had quit smoking before late pregnancy (weeks 30 to 32) had an adjusted OR for term preeclampsia of 0.94 (95% CI: 0.83 to 1.08). The corresponding OR for women who did not use tobacco in early pregnancy but had started to smoke before late pregnancy was 0.65 (95% CI: 0.50 to 0.85). We conclude that tobacco combustion products rather than nicotine are the probable protective ingredients against preeclampsia in cigarette smoke. Because change of smoking habits during pregnancy influence risk, we further conclude that it is the smoking habits in the middle or late rather than in the beginning of pregnancy that seem to affect the risk of preeclampsia. (Hypertension. 2010;55:1254-1259.)

Factors associated with Specific Hypertensive Gestation Syndrome (SHGS) in postpartum adolescent and young adult mothers in the Northeast of Brazil: a multiple analysis of hierarchical models

“…For the use of tobacco during gestation, the results of the present study ratify researches carried out at the national level, in Maternities of the States of the Northeast, 19 Southeast 23 and Southern Regions of Brazil, 23 as well as with research data from other countries with women of Nordic countries 26 (Sweden, Norway, Denmark, Finland and Iceland), since no significant associations were found.…”

Elevated carboxyhemoglobin in a marine mammal, the northern elephant seal

“…For example, in the llama (Lama glama) at high altitude, elevated pulmonary CO production is associated with decreased pulmonary hypertension (Herrera et al, 2008). And lastly, although smoking during pregnancy is associated with numerous adverse outcomes and low birth weights (Cnattingius and Lambe, 2002), there has been shown to be an associated decreased risk of hypertension and pre-eclampsia (Wikström et al, 2010). Thus, elevated CO may also contribute to vascular regulation for coping with hypoxemia and tissue vasoconstriction during breath-holding in seals (Ponganis et al, 2008;Meir et al, 2009).…”

Cigarette Smoke-Induced Placental Adrenomedullin Expression and Trophoblast Cell Invasion

“…3,26,27 Multiple studies have demonstrated that smoking during pregnancy reduces the risk of developing preeclampsia by approximately 50%. 5,6,28,29 Wikstrom et al evaluated preeclampsia risk in smokers and found that the risk reduction did not apply to women who smoked in the first trimester but quit by the onset of the third trimester, rather smoking throughout pregnancy provided greatest protection. 6 Moreover, the same group found that the use of smokeless tobacco (ie, snuff) conferred no protection from preeclampsia.…”