Maternal Smoking by Trimester of Pregnancy and Risk of Small-for-Gestational-Age
Methods: Data were obtained from the 2009 Natality public use file available through National Center for Health Statistics. Multivariable log-linear regression models were performed to determine the association between percentile of SGA outcome (3rd, 5th and 10th) and trimester and dosage of tobacco exposure.
Results: Hypertension and smoking appeared to work synergistically to restrict fetal growth. Women who smoked moderately in all three trimesters and had hypertension were 4.34 times more likely to give birth to a 3rd percentile SGA infant compared to non-smoking normotensive women. However, the effect of hypertension was protective for giving birth to a 10th percentile SGA infant among women who smoked moderately across all three trimesters.
Conclusions: The timing and duration of tobacco exposures mediate the risk and severity of fetal growth restriction. This relationship was modified by presence of hypertension which may indicate different etiologies between pathologically growth restricted infants and constitutionally growth restricted infants.
Public health or related research
Identify the effect of tobacco exposure on small-for-gestational infants (SGA). Compare birth outcomes by trimester of tobacco exposure. Analyze the role of hypertension in modifying the effect of tobacco. Demonstrate that there are differences in outcome by percentile SGA.
Keyword(s): Tobacco Use, Perinatal Health
Qualified on the content I am responsible for because: I have co-authored numerous publications in the area of perinatal epidemiology. I hold a masters in public health specializing in epidemiology and I am currently pursuing a doctoral degree with an emphasis in maternal and child health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.