期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 168, 期 4, 页码 427-433出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwn140
关键词
body weight; infant; small for gestational age; overweight; pre-eclampsia; pregnancy; smoking
资金
- NCRR NIH HHS [M01 RR000056, 5MO1 RR00056, M01 RR000056-430894] Funding Source: Medline
- NICHD NIH HHS [P01 HD030367-119001, P01 HD030367-08S19001, P01 HD030367-07S19001, P01 HD030367-069001, P01 HD030367-079001, P01 HD030367-089001, P01 HD30367, P01 HD030367-099001, P01 HD030367-06S19001, P01 HD030367-129001, P01 HD030367-04A19001, P01 HD030367, P01 HD030367-109001, P01 HD030367-059001, P01 HD030367-139001] Funding Source: Medline
Cigarette smoking protects against preeclampsia but increases the risk of small-for-gestational-age birth (SGA). Regarding body weight, the converse is true: obesity elevates rates of preeclampsia but reduces rates of SGA. The authors assessed the combined effects of smoking and weight among US women developing preeclampsia or SGA, studying 7,757 healthy, primigravid women with singleton pregnancies in 1959-1965. Smoking (never, light, heavy), stratified by prepregnancy body mass index (BMI (weight (kg)/height (m)(2)); underweight, overweight, obese), was examined in relation to preeclampsia and SGA. Among underweight (BMI < 18.5) and normal-weight (BMI 18.5-24.9) women, smoking decreased the risk of preeclampsia (for heavy smoking, light smoking, nonsmoking, test for trend > = 0.002 for underweight and p = 0.009 for normal weight) after adjustment for age, race, and socioeconomic status. However, among overweight/obese women (BMI >= 25), this trend was not apparent (p = 0.4). Among both underweight and overweight women, smoking significantly increased SGA risk (trend p < 0.001 for underweight and p = 0.02 for overweight/obese). Obesity eliminated the inverse association between smoking and preeclampsia but did not substantially alter the positive association between smoking and SGA. A possible unifying biologic explanation is discussed in this paper.
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