First-trimester smoking cessation in pregnancy did not increase the risk of preeclampsia/eclampsia : a Murmansk county birth registry study

Abstract

BACKGROUND : Although prior studies have shown that smoking reduces preeclampsia/eclampsia risk, the consequence of giving up this habit during pregnancy should be assessed. The aims of the current study were threefold: (i) describe maternal characteristics of women with preeclampsia/ eclampsia; (ii) examine a possible association between the number of cigarettes smoked daily during pregnancy and the development of this affliction; and (iii) determine if first-trimester discontinuation of smoking during pregnancy influences the risk. METHODS : A registry-based study was conducted using data from the Murmansk County Birth Registry (MCBR). It included women without pre-existing hypertension, who delivered a singleton infant during 2006±2011 and had attended the first antenatal visit before 12 week of gestation. We adjusted for potential confounders using logistic regression. RESULTS : The prevalence of preeclampsia/eclampsia was 8.3% (95%CI: 8.0±8.6). Preeclampsia/ eclampsia associated with maternal age, education, marital status, parity, excessive weight gain and body mass index at the first antenatal visit. There was a dose-response relationship between the number of smoked cigarettes per day during pregnancy and the risk of preeclampsia/ eclampsia (adjusted OR1-5 cig/day = 0.69 with 95%CI: 0.56±0.87; OR6-10 cig/day = 0.65 with 95%CI: 0.51±0.82; and OR 11 cig/day = 0.49 with 95%CI: 0.30±0.81). There was no difference in this risk among women who smoked before and during pregnancy and those who did so before but not during pregnancy (adjusted OR = 1.10 with 95%CI: 0.91±1.32). CONCLUSIONS : Preeclampsia/eclampsia was associated with maternal age, education, marital status, parity, excessive weight gain, and body mass index at the first antenatal visit. There was a negative dose-response relationship between the number of smoked cigarettes per day during pregnancy and the odds of preeclampsia/eclampsia. However, women who gave up smoking during the first trimester of gestation had the same risk of preeclampsia/eclampsia as those who smoked while pregnant. Consequently, antenatal clinic specialists are advised to take these various observations into account when counselling women on smoking cessation during pregnancy.