IJE Advance Access published online on November 22, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi247
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1 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ontario, Canada; Ottawa Health Research Institute, Clinical Epidemiology Program, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ontario, Canada
* To whom correspondence should be addressed. Background Although previous studies have found that maternal smoking decreases the risk of pregnancy-induced hypertension (PIH), the difference of this effect between primiparous and multiparous women has not been well studied and the results of the exposure-response relationships between maternal smoking and PIH are inconsistent. No previous study has specifically examined the relationship between maternal smoking and eclampsia. Methods We analysed data from a population-based retrospective cohort study of 3 153 944 singleton pregnancies in the US. The data were derived from the national linked birth/infant mortality database for 1998. Multiple logistic regressions were used to describe the relationship between cigarette smoking and PIH and eclampsia. Results The adjusted odds ratios (ORs) [95% confidence intervals (95% CIs)] for PIH were 0.80 (0.77-0.83) for primiparous women and 0.81 (0.78-0.83) for multiparous women among smokers compared with non-smokers. The corresponding adjusted ORs (95% CIs) for eclampsia were 0.74 (0.66-0.82) and 0.75 (0.68-0.83), respectively. For PIH, the adjusted OR (95% CI) for smokers vs non-smokers were 0.82 (0.79-0.86), 0.81 (0.78-0.83), 0.80 (0.77-0.83), and 0.88 (0.79-0.98), respectively, for 1-5, 6-10, 11-20, and >20 cigarettes per day (test for trend: P = 0.86). The corresponding figures for eclampsia were 0.85 (0.75-0.95), 0.74 (0.66-0.82), 0.68 (0.58-0.78), and 0.73 (0.49-1.04), respectively (test for trend: P = 0.02). Conclusion Maternal cigarette smoking decreases the risk of PIH and eclampsia, with a significant inverse exposure-response relationship apparent for eclampsia.
Accepted October 13, 2005
Original paper
Maternal cigarette smoking and the risk of pregnancy-induced hypertension and eclampsia
Qiuying Yang 1 *,
Shi Wu Wen 2,
Graeme N. Smith 3,
Yue Chen 4,
Daniel Krewski 4,
Xi Kuan Chen 5,
and
Mark C. Walker 5
2 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ontario, Canada; Ottawa Health Research Institute, Clinical Epidemiology Program, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada
3 Queen's Perinatal Research Unit, Queen's University, Ontario, Canada
4 McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ontario, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada
5 OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Faculty of Medicine, Ontario, Canada; Ottawa Health Research Institute, Clinical Epidemiology Program, Ontario, Canada
Qiuying Yang, E-mail: qyang{at}ohri.ca
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