The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes

K. R. Contreras, M. A. Kominiarek, T. W. Zollinger

    Research output: Contribution to journalArticle

    4 Citations (Scopus)

    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 ≤3, birth defects, and neonatal intensive care unit (NICU) admissions. ξ2 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.

    Original languageEnglish
    Pages (from-to)319-323
    Number of pages5
    JournalJournal of Perinatology
    Volume30
    Issue number5
    DOIs
    StatePublished - May 2010

    Fingerprint

    Gestational Diabetes
    Smoking
    Pregnancy
    Gestational Age
    Odds Ratio
    Confidence Intervals
    Dystocia
    Apgar Score
    Neonatal Intensive Care Units
    Logistic Models
    Regression Analysis
    Parturition
    Peripartum Period
    Postpartum Hemorrhage
    Premature Obstetric Labor
    Maternal Age
    Wounds and Injuries
    Live Birth
    Tobacco Use
    Pre-Eclampsia

    Keywords

    • Gestational diabetes
    • Large for gestational age infants
    • Tobacco smoking

    ASJC Scopus subject areas

    • Obstetrics and Gynecology
    • Pediatrics, Perinatology, and Child Health

    Cite this

    The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes. / Contreras, K. R.; Kominiarek, M. A.; Zollinger, T. W.

    In: Journal of Perinatology, Vol. 30, No. 5, 05.2010, p. 319-323.

    Research output: Contribution to journalArticle

    Contreras, K. R. ; Kominiarek, M. A. ; Zollinger, T. W. / The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes. In: Journal of Perinatology. 2010 ; Vol. 30, No. 5. pp. 319-323.
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    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 ≤3, birth defects, and neonatal intensive care unit (NICU) admissions. ξ2 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.",
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    AB - 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 ≤3, birth defects, and neonatal intensive care unit (NICU) admissions. ξ2 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.

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