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To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.
This retrospective cohort study was based on the U.S. 2010 natality data. Our study sample included U.S. women who delivered singleton pregnancies between 20 and 44 weeks of gestation without major fetal anomalies in 2010 (n = 3,113,164). Multivariate logistic regression models were fit to estimate crude and adjusted odds ratios and the corresponding 95% confidence intervals.
We observed that the association between maternal smoking and PIH varied by maternal race/ethnicity and age. Compared with non-smokers, reduced odds of PIH among pregnant smokers was only evident for non-Hispanic white and non-Hispanic American Indian women aged less than 35 years. Non-Hispanic Asian/Pacific Islander women who smoked during pregnancy had increased odds of PIH regardless of maternal age. Non-Hispanic white and non-Hispanic black women 35 years or older who smoked during pregnancy also had increased odds of PIH.
Our study findings suggest important differences by maternal race/ethnicity and age in the association between cigarette use during pregnancy and PIH. More research is needed to establish the biologic and social mechanisms that might explain the variations with maternal age and race/ethnicity that were observed in our study.
Copyright: © 2014 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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VCU Obstetrics and Gynecology Publications
Reassessing the Impact of Smoking on Preeclampsia/Eclampsia: Are There Age and Racial Differences? Chang JJ, Strauss JF III, Deshazo JP, Rigby FB, Chelmow DP, et al. (2014) Reassessing the Impact of Smoking on Preeclampsia/Eclampsia: Are There Age and Racial Differences? PLoS ONE 9(10): e106446. doi: 10.1371/journal.pone.0106446
Odds Ratios for the Effect of Smoking on PIH Among Ethnic Groups. doi:10.1371/journal.pone.0106446.s001
journal.pone.0106446.s002.DOCX (15 kB)
Odds Ratios for the Effect of Smoking on PIH Among Ethnic Groups by Maternal Age. doi:10.1371/journal.pone.0106446.s002