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The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes.
J Perinatol 2010; 30(5):319-23JP

Abstract

OBJECTIVE

To determine the effects of tobacco use on perinatal outcomes among patients with gestational diabetes (GDM).

STUDY DESIGN

This was a retrospective cohort study of singleton pregnancies with GDM and live births from 2003 to 2006. The primary outcome, large for gestational age (LGA) infants, was compared between smoking and nonsmoking groups. Secondary outcomes included cesarean deliveries, shoulder dystocia, birth trauma, peripartum complications, macrosomia, 5-min Apgar score < or =3, birth defects, and neonatal intensive care unit (NICU) admissions. chi(2) and Student t-tests compared the two groups; a P-value <0.05 was statistically significant and odds ratios (OR) were reported with 95% confidence intervals (CI). A multivariate logistic regression analysis controlled for variables known to affect outcomes in GDM.

RESULT

We identified 915 patients with GDM, of which 130 (14.2%) smoked during pregnancy. Women who smoked during pregnancy were less likely to have LGA infants (22.4 vs 31.2%; OR, 0.61; 95% CI, 0.39 to 0.95). In a logistic regression analysis, the inverse relationship between smoking and LGA persisted (OR, 0.59; 95% CI, 0.36 to 0.97) after controlling for maternal age, multiparity, ethnicity, weight status before pregnancy, weight gain during pregnancy, and male gender. Preterm labor, preeclampsia, Cesareans, shoulder dystocia, and birth trauma were similar in both groups. PPROM was more likely to occur in nonsmokers (0 vs 4%, P=0.03), but postpartum hemorrhage was more common among smokers (OR, 2.3; 95% CI, 1.02 to 5.31). Macrosomia, low 5-min Apgar score, birth defects, and NICU admissions were similar between the groups.

CONCLUSION

Patients with GDM who smoke during pregnancy were 40% less likely to have LGA infants. However, smoking was not protective of other common morbidities associated with GDM.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN 60153, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19907429

Citation

Contreras, K R., et al. "The Impact of Tobacco Smoking On Perinatal Outcome Among Patients With Gestational Diabetes." Journal of Perinatology : Official Journal of the California Perinatal Association, vol. 30, no. 5, 2010, pp. 319-23.
Contreras KR, Kominiarek MA, Zollinger TW. The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes. J Perinatol. 2010;30(5):319-23.
Contreras, K. R., Kominiarek, M. A., & Zollinger, T. W. (2010). The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes. Journal of Perinatology : Official Journal of the California Perinatal Association, 30(5), pp. 319-23. doi:10.1038/jp.2009.175.
Contreras KR, Kominiarek MA, Zollinger TW. The Impact of Tobacco Smoking On Perinatal Outcome Among Patients With Gestational Diabetes. J Perinatol. 2010;30(5):319-23. PubMed PMID: 19907429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes. AU - Contreras,K R, AU - Kominiarek,M A, AU - Zollinger,T W, Y1 - 2009/11/12/ PY - 2009/11/13/entrez PY - 2009/11/13/pubmed PY - 2010/9/15/medline SP - 319 EP - 23 JF - Journal of perinatology : official journal of the California Perinatal Association JO - J Perinatol VL - 30 IS - 5 N2 - OBJECTIVE: To determine the effects of tobacco use on perinatal outcomes among patients with gestational diabetes (GDM). STUDY DESIGN: This was a retrospective cohort study of singleton pregnancies with GDM and live births from 2003 to 2006. The primary outcome, large for gestational age (LGA) infants, was compared between smoking and nonsmoking groups. Secondary outcomes included cesarean deliveries, shoulder dystocia, birth trauma, peripartum complications, macrosomia, 5-min Apgar score < or =3, birth defects, and neonatal intensive care unit (NICU) admissions. chi(2) and Student t-tests compared the two groups; a P-value <0.05 was statistically significant and odds ratios (OR) were reported with 95% confidence intervals (CI). A multivariate logistic regression analysis controlled for variables known to affect outcomes in GDM. RESULT: We identified 915 patients with GDM, of which 130 (14.2%) smoked during pregnancy. Women who smoked during pregnancy were less likely to have LGA infants (22.4 vs 31.2%; OR, 0.61; 95% CI, 0.39 to 0.95). In a logistic regression analysis, the inverse relationship between smoking and LGA persisted (OR, 0.59; 95% CI, 0.36 to 0.97) after controlling for maternal age, multiparity, ethnicity, weight status before pregnancy, weight gain during pregnancy, and male gender. Preterm labor, preeclampsia, Cesareans, shoulder dystocia, and birth trauma were similar in both groups. PPROM was more likely to occur in nonsmokers (0 vs 4%, P=0.03), but postpartum hemorrhage was more common among smokers (OR, 2.3; 95% CI, 1.02 to 5.31). Macrosomia, low 5-min Apgar score, birth defects, and NICU admissions were similar between the groups. CONCLUSION: Patients with GDM who smoke during pregnancy were 40% less likely to have LGA infants. However, smoking was not protective of other common morbidities associated with GDM. SN - 1476-5543 UR - https://www.unboundmedicine.com/medline/citation/19907429/The_impact_of_tobacco_smoking_on_perinatal_outcome_among_patients_with_gestational_diabetes_ L2 - http://dx.doi.org/10.1038/jp.2009.175 DB - PRIME DP - Unbound Medicine ER -