© 1992 Oxford University Press
other |
Reinterpreting the Effects of Maternal Smoking on Infant Birthweight and Perinatal Mortality: A Multivariate Approach to Birthweight Standardization
Maternal and Child Health and Epidemiology Programs, School of Public Health, Univeralty of California Berkeley. CA 94720, USA
Reprint requests: Dr Brenda Eskenazi, 312 Warren Hall, School of Public Health, University of California, Berkeley, CA 94720, USA
Infants of women who smoke during pregnancy have lower birthweights and have been observed to have higher rates of perinatal mortality than infants of non-smokers. It is not clear whether this Increased risk of mortality is due to an excess of small births among smokers or to an independent effect of smoking. Although infants of smokers have overall higher mortality rates than non-smokers, low birthweight (<2500 g) infants of smokers have lower mortality rates than low birthweight infants of non-smokers. However, comparison of birthwelght-specific mortality between two groups is problematic when there are differences in the birthwelght distributions. Methods that have been developed to standardize for these differences by comparing mortality rates relative to their own mean do not allow for simultaneous control of confounding variables. Using data from over 13000 births of women who participated in a prepaid health care plan we present a method to standardize for birthwelght while adjusting for variables that may con found the relationship between maternal smoking and perinatal mortality. After controlling for race, maternal age, education, parity, and number of cigarettes smoked, we found that 85% of the increased mortality due to smoking was attributable to en excess of small births In the birthweight distribution of offspring of smoking mothers, while 15% was due to higher birthweight-specffic mortality at almost all standardized birthweights. Contrary to previous reports, we found that low birthweight infants of smoking mothers are at higher risk of perinatal mortality if a population-specific standard for blrthweight is used.
Revised 1 June 1992
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. Malik, M. A. Cleves, M. A. Honein, P. A. Romitti, L. D. Botto, S. Yang, C. A. Hobbs, and and the National Birth Defects Prevention Study Maternal Smoking and Congenital Heart Defects Pediatrics, April 1, 2008; 121(4): e810 - e816. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Platt, K. S. Joseph, C. V. Ananth, J. Grondines, M. Abrahamowicz, and M. S. Kramer A Proportional Hazards Model with Time-dependent Covariates and Time-varying Effects for Analysis of Fetal and Infant Death Am. J. Epidemiol., August 1, 2004; 160(3): 199 - 206. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Hafstrom, J. Milerad, and H. W. Sundell Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb Am. J. Respir. Crit. Care Med., July 1, 2002; 166(1): 92 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. Lie Invited Commentary: Intersecting Perinatal Mortality Curves by Gestational Age-Are Appearances Deceiving? Am. J. Epidemiol., December 15, 2000; 152(12): 1117 - 1119. [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. NAJMAN, W. BOR, M. J. ANDERSEN, M. O'CALLAGHAN, and G. M. WILLIAMS Preschool Children and Behaviour Problems: A Prospective Study Childhood, November 1, 2000; 7(4): 439 - 466. [Abstract] [PDF]
|
|
|
|
 |
|
 D. M. Fergusson Prenatal Smoking and Antisocial Behavior Arch Gen Psychiatry, March 1, 1999; 56(3): 223 - 224. [Full Text] [PDF]
|
|
|
|
|
|
D. M. Fergusson, L. J. Woodward, and L. J. Horwood Maternal Smoking During Pregnancy and Psychiatric Adjustment in Late Adolescence Arch Gen Psychiatry, August 1, 1998; 55(8): 721 - 727. [Abstract] [Full Text] [PDF]
|
|