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Impact of smoking and fetal gender on preterm delivery

Published online by Cambridge University Press:  13 November 2020

Veronika Günther*
Affiliation:
Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), KielD-24105, Germany
Ibrahim Alkatout
Affiliation:
Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), KielD-24105, Germany
Alexandra Stein
Affiliation:
Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), KielD-24105, Germany
Nicolai Maass
Affiliation:
Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (Building C), KielD-24105, Germany
Alexander Strauss
Affiliation:
Christian-Albrechts-University zu Kiel, Kiel24118, Germany
Manfred Voigt
Affiliation:
Department of Gynecology, University Hospital Freiburg, Hugstetter Str. 55, Freiburg79106, Germany Biological Anthropology, University Hospital Freiburg, Hebelstr. 29, Freiburg79104, Germany
*
Address for correspondence: Veronika Günther, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building C, Kiel24105, Germany. Email: veronika.guenther@uksh.de

Abstract

According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. We aimed to establish how fetal gender and smoking interact with regard to perinatal outcomes, especially preterm delivery. Data from 220,339 singleton pregnancies, obtained from the German Perinatal Survey in Schleswig-Holstein and registered between 2004 and 2017 were analyzed in regard to smoking behavior, fetal gender, and preterm delivery. The rate of preterm births was directly proportional to the women’s consumption of nicotine. The rate of preterm deliveries was 6.8% among nonsmokers, and 13.2% in women who were very heavy smokers (≥22 cigarettes/day). Very heavy smoking (≥22 cigarettes/day) had a marked impact on extremely preterm births (<28 weeks of gestation) and very preterm births (28–31 weeks of gestation). Preterm births increased by 1.2% from heavy smokers to very heavy smokers; the differences between the other groups ranged between 0.1% and 0.4%. Fetal gender also had an impact on preterm birth: male infants were predominant in nearly all groups of women who delivered preterm infants. Smoking during pregnancy and male gender are both risk factors for preterm delivery. Fetal gender should be given greater attention as one of the several risk factors of preterm birth. Due to the high rate of morbidity among preterm infants and enormous costs for the healthcare system, women should be encouraged to cease or at least reduce smoking during pregnancy.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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