• S Baba, A-K Wikström, O Stephansson, and S Cnattingius.
• Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden. Sachiko.baba@ki.se
• BJOG. 2013 Mar 1; 120 (4): 456-62.

ObjectiveTo examine associations between antenatal exposure to Swedish oral moist snuff (which includes essentially only nicotine) and to smoking and risks of small-for-gestational-age (SGA) births and to compare risks among women who stopped or continued using snuff or smoking during pregnancy.DesignPopulation-based cohort study.SettingSweden.PopulationAll live singleton births in Sweden 1999-2010.MethodsOdds ratios (OR) with 95% confidence intervals (CI) were calculated using multiple logistic regression analysis.Main Outcome MeasuresSGA birth, also stratified into preterm (≤36 weeks of gestation) and term (≥37 weeks of gestation) SGA births.ResultsCompared with non-tobacco users in early pregnancy, snuff users and above all smokers in early pregnancy had increased risks of SGA births: adjusted ORs (95% CI) were 1.26 (1.09-1.46) and 2.55 (2.43-2.67), respectively). Snuff use had, if anything, a stronger association with preterm SGA than term SGA, whereas the opposite was true for smoking. Compared with non-tobacco users, women who stopped using snuff before their first visit to antenatal care had no increased risks of preterm or term SGA, and women who stopped using snuff later during pregnancy had no increased risk of term SGA. Smoking cessation early in pregnancy was associated with a larger reduction in risk than smoking cessation later in pregnancy.ConclusionsAs both smoking and snuff use influence risk of SGA, both nicotine but above all tobacco combustion products are involved in the mechanisms by which maternal smoking increases the risk of SGA.© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

30 keywords...

hide…