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Type: Journal article
Title: Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study
Author: McCowan, L.
Dekker, G.
Chan, E.
Stewart, A.
Chappell, L.
Hunter, M.
Moss-Morris, R.
North, R.
Citation: BMJ: British Medical Journal, 2009; 338(7710):1-6
Publisher: British Med Journal Publ Group
Issue Date: 2009
ISSN: 0959-535X
Statement of
Lesley M E McCowan, Gustaaf A Dekker, Eliza Chan, Alistair Stewart, Lucy C Chappell, Misty Hunter, Rona Moss-Morris and Robyn A North
Abstract: <h4>Objectives</h4>To compare pregnancy outcomes between women who stopped smoking in early pregnancy and those who either did not smoke in pregnancy or continued to smoke.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Auckland, New Zealand and Adelaide, Australia.<h4>Participants</h4>2504 nulliparous women participating in the Screening for Pregnancy Endpoints (SCOPE) study grouped by maternal smoking status at 15 (+/-1) week's gestation.<h4>Main outcome measures</h4>Spontaneous preterm birth and small for gestational age infants (birth weight <10th customised centile). We compared odds of these outcomes between stopped smokers and non-smokers, and between current smokers and stopped smokers, using logistic regression, adjusting for demographic and clinical risk factors.<h4>Results</h4>80% (n=1992) of women were non-smokers, 10% (n=261) had stopped smoking, and 10% (n=251) were current smokers. We noted no differences in rates of spontaneous preterm birth (4%, n=88 v 4%, n=10; adjusted odds ratio 1.03, 95% confidence interval l0.49 to 2.18; P=0.66) or small for gestational age infants (10%, n=195 v 10%, n=27; 1.06, 0.67 to 1.68; P=0.8) between non-smokers and stopped smokers. Current smokers had higher rates of spontaneous preterm birth (10%, n=25 v 4%, n=10; 3.21, 1.42 to 7.23; P=0.006) and small for gestational age infants (17%, n=42 v 10%, n=27; 1.76, 1.03 to 3.02; P=0.03) than stopped smokers.<h4>Conclusion</h4>In women who stopped smoking before 15 weeks' gestation, rates of spontaneous preterm birth and small for gestational age infants did not differ from those in non-smokers, indicating that these severe adverse effects of smoking may be reversible if smoking is stopped early in pregnancy.
Keywords: SCOPE consortium
Premature Birth
Pregnancy Outcome
Prospective Studies
Smoking Cessation
Pregnancy Trimester, First
Infant, Newborn
Infant, Small for Gestational Age
DOI: 10.1136/bmj.b1081
Appears in Collections:Aurora harvest 5
Obstetrics and Gynaecology publications

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