Article Text

other Versions

PDF
Smoking cessation in the first trimester reduces most obstetric risks, but not the risks of major congenital anomalies and admission to neonatal care: a population-based cohort study of 1 164 953 singleton pregnancies in Finland
  1. Sari Räisänen1,
  2. Ulla Sankilampi2,
  3. Mika Gissler3,4,
  4. Michael R Kramer5,
  5. Tuovi Hakulinen-Viitanen3,
  6. Juho Saari6,7,
  7. Seppo Heinonen1,8
  1. 1Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland
  2. 2Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
  3. 3National Institute for Health and Welfare (THL), Helsinki, Finland
  4. 4Nordic School of Public Health, Gothenburg, Sweden
  5. 5Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
  6. 6Kuopio Welfare Research Centre (KWRC), The University of Eastern Finland, Kuopio, Finland
  7. 7Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
  8. 8University of Eastern Finland, Kuopio, Finland
  1. Correspondence to Dr Sari Räisänen, Kys PO Box 100, FI-70029 Kys, Kuopio, Finland; shraisan{at}student.uef.fi

Abstract

Background In industrialised countries, approximately 5–20% of women smoke during pregnancy. We aim to study the association between smoking during pregnancy and adverse perinatal outcomes.

Methods A retrospective population–based cohort study using data on all singleton births between 1991 and 2010 (n=1 164 953) derived from the Finnish Medical Birth Register.

Results Of all the mothers included, 82.3% were non-smokers, 2.6% quit smoking during the first trimester of pregnancy, 12.5% smoked throughout pregnancy and 2.7% had no information on smoking. Continuing smoking after the first trimester of the pregnancy was associated with an increased prevalence of admission to a neonatal intensive care unit, stillbirth, preterm birth (<37 gestational weeks), low birth weight (LBW, <2500 g), small for gestational age (SGA, <−2 SDs) and major congenital anomaly compared with non-smokers. Smoking cessation reduced the risk of prematurity, stillbirth, LBW and SGA close to or at similar levels as those of non-smokers. Tobacco exposure in early pregnancy resulted in a 19% increased prevalence of admission to neonatal intensive care unit and a 22% increased prevalence of major congenital anomaly compared with non-smokers.

Conclusions Smoking cessation appeared to reduce pregnancy risks close to those of non-smoking peers. Exposure to early pregnancy smoking was, however, associated with an increased admission to neonatal intensive care and an increased prevalence of major congenital anomalies.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.