Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T09:16:20.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of smoking and fetal gender on preterm delivery

Published online by Cambridge University Press:  13 November 2020

Veronika Günther Open the ORCID record for Veronika Günther [Opens in a new window] ,
Ibrahim Alkatout ,
Alexandra Stein ,
Nicolai Maass ,
Alexander Strauss  and
Manfred Voigt
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: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Pregnancysmokingnicotine abusefetal genderpreterm delivery
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 4 , August 2021 , pp. 632 - 637
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hamilton, BE, Martin, JA, Ventura, SJ. Births: preliminary data for 2005. Natl Vital Stat Rep. 2006; 55(11), 1–18.Google ScholarPubMed
Slattery, MM, Morrison, JJ. Preterm delivery. Lancet. 2002; 360(9344), 1489–1497.CrossRefGoogle ScholarPubMed
Dahlin, S, Gunnerbeck, A, Wikström, A-K, Cnattingius, S, Edstedt Bonamy, A-K. Maternal tobacco use and extremely premature birth - a population-based cohort study. BJOG. 2016; 123(12), 1938–1946.CrossRefGoogle ScholarPubMed
Goldenberg, RL, Culhane, JF, Iams, JD, Romero, R. Epidemiology and causes of preterm birth. Lancet. 2008; 371(9606), 75–84.CrossRefGoogle ScholarPubMed
Liu, L, Oza, S, Hogan, D, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016; 388(10063), 3027–3035.CrossRefGoogle ScholarPubMed
Howson, CP, Kinney, MV, McDougall, L, Lawn, JE. Born too soon: preterm birth matters. Reprod Health. 2013; 10 Suppl 1, S1.CrossRefGoogle Scholar
Behrman, RE, Butler, AS. Preterm Birth: Causes, Consequences, and Prevention, 2007. Washington (DC): National Academies Press (US).Google Scholar
Kanmaz, AG, İnan, AH, Beyan, E, et al. Effects of fetal gender and low first trimester aneuploidy screening markers on preterm birth. J Gynecol Obstet Hum Reprod. 2019; 48(8), 649–652.CrossRefGoogle ScholarPubMed
Peelen, MJ, Kazemier, BM, Ravell, ACJ, et al. Impact of fetal gender on the risk of preterm birth, a national cohort study. Acta Obstet Gynecol Scand. 2016; 95(9), 1034–1041.CrossRefGoogle ScholarPubMed
Zeitlin, J, Saurel-Cubizolles, M-J, de Mouzon, J, et al. Fetal sex and preterm birth: are males at greater risk? Hum Reprod. 2002; 17(10), 2762–2768.CrossRefGoogle ScholarPubMed
Cnattingius, S, The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob Res. 2004; 6 Suppl 2, S125–S140.CrossRefGoogle Scholar
Curtin, SC, Matthews, TJ, Smoking prevalence and cessation before and during pregnancy: data from the birth certificate, 2014. Natl Vital Stat Rep. 2016; 65(1), 1–14.Google ScholarPubMed
Kyrklund-Blomberg, NB, Granath, F, Cnattingius, S, Maternal smoking and causes of very preterm birth. Acta Obstet Gynecol Scand. 2005; 84(6), 572–577.CrossRefGoogle ScholarPubMed
Raisanen, S, Gissler, M, Saari, J, Kramer, M, Heinonen, S. Contribution of risk factors to extremely, very and moderately preterm births - register-based analysis of 1,390,742 singleton births. PLoS One. 2013; 8(4), e60660.CrossRefGoogle ScholarPubMed
Lanting, CI, Buitendijk, SE, Crone, MR, Segaar, D, Gravenhorst, JB, van Wouwe, JP. Clustering of socioeconomic, behavioural, and neonatal risk factors for infant health in pregnant smokers. PLoS One. 2009; 4(12), e8363.CrossRefGoogle ScholarPubMed
Jauniaux, E, Burton, GJ, Morphological and biological effects of maternal exposure to tobacco smoke on the feto-placental unit. Early Hum Dev. 2007; 83(11), 699–706.CrossRefGoogle ScholarPubMed
Ashfaq, M, Janjua, MZ, Nawaz, M, Effects of maternal smoking on placental morphology. J Ayub Med Coll Abbottabad. 2003; 15(3), 12–15.Google ScholarPubMed
Jaddoe, VW, Troe, E-JWM, Hofman, A, et al. Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study. Paediatr Perinat Epidemiol. 2008; 22(2), 162–171.CrossRefGoogle ScholarPubMed
Shah, NR, Bracken, MB. A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol. 2000; 182(2), 465–472.CrossRefGoogle ScholarPubMed
McCowan, LM, Dekker, GA, Chan, E, et al. Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. 2009; 338, b1081.CrossRefGoogle ScholarPubMed
Jacob, J, Lehne, M, Mischker, A, Klinger, N, Zickermann, C, Walker, J. Cost effects of preterm birth: a comparison of health care costs associated with early preterm, late preterm, and full-term birth in the first 3 years after birth. Eur J Health Econ. 2017; 18(8), 1041–1046.CrossRefGoogle ScholarPubMed
St John, EB, Nelson, KG, Cliver, SP, Bishnoi, RR, Goldenberg, RL. Cost of neonatal care according to gestational age at birth and survival status. Am J Obstet Gynecol. 2000; 182(1 Pt 1), 170–175.CrossRefGoogle ScholarPubMed
Clements, KM, Barfield, WD, Ayadi, MF, Wilber, N. Preterm birth-associated cost of early intervention services: an analysis by gestational age. Pediatrics. 2007; 119(4), e866–e874.CrossRefGoogle ScholarPubMed
Verloove-Vanhorick, SP, Veen, S, Ens-Dokkum, MH, Schreuder, AM, Brand, R, Ruys, JH. Sex difference in disability and handicap at five years of age in children born at very short gestation. Pediatrics. 1994; 93(4), 576–579.Google ScholarPubMed
Smith, GC. Sex, birth weight, and the risk of stillbirth in Scotland, 1980-1996. Am J Epidemiol. 2000; 151(6), 614–619.CrossRefGoogle Scholar
Stevenson, DK, Verter, J, Fanaroff, A. Sex differences in outcomes of very low birthweight infants: the newborn male disadvantage. Arch Dis Child Fetal Neonatal Ed. 2000; 83(3), F182–F185.CrossRefGoogle ScholarPubMed
Astolfi, P, Zonta, LA. Risks of preterm delivery and association with maternal age, birth order, and fetal gender. Hum Reprod. 1999; 14(11), 2891–2894.CrossRefGoogle ScholarPubMed
Hall, MH, Carr-Hill, R. Impact of sex ratio on onset and management of labour. Br Med J (Clin Res Ed). 1982; 285(6339), 401–403.CrossRefGoogle ScholarPubMed
McGregor, JA, Leff, M, Orleans, M, Baron, A. Fetal gender differences in preterm birth: findings in a North American cohort. Am J Perinatol. 1992; 9(1), 43–48.CrossRefGoogle Scholar
MacGillivray, I, Davey, DA. The influence of fetal sex on rupture of the membranes and preterm labor. Am J Obstet Gynecol. 1985; 153(7), 814–815.CrossRefGoogle ScholarPubMed
Cooperstock, M, Campbell, J. Excess males in preterm birth: interactions with gestational age, race, and multiple birth. Obstet Gynecol. 1996; 88(2), 189–193.CrossRefGoogle ScholarPubMed
Challis, J, Newnham, J, Petraglia, F, Yeganegi, M, Bocking, A. Fetal sex and preterm birth. Placenta. 2013; 34(2), 95–99.CrossRefGoogle ScholarPubMed
James, WH, Cycle day of insemination, sex ratio of offspring and duration of gestation. Ann Hum Biol. 1994; 21(3), 263–266.CrossRefGoogle ScholarPubMed
James, WH, Why are boys more likely to be preterm than girls? Plus other related conundrums in human reproduction. Hum Reprod. 2000; 15(10), 2108–2111.CrossRefGoogle ScholarPubMed
Zeitlin, J, Ancel, P-Y, Larroque, B, Kaminski, M, EPIPAGE Study. Fetal sex and indicated very preterm birth: results of the EPIPAGE study. Am J Obstet Gynecol. 2004; 190(5), 1322–1325.CrossRefGoogle ScholarPubMed
Kim, SH, Shim, SH, Sung, SR, et al. Gene expression analysis of the microdissected trophoblast layer of human placenta after the spontaneous onset of labor. PLoS One. 2013; 8(10), e77648.CrossRefGoogle ScholarPubMed
Muglia, LJ, Katz, M. The enigma of spontaneous preterm birth. N Engl J Med. 2010; 362(6), 529–535.CrossRefGoogle ScholarPubMed
Ghidini, A, Salafia, CM. Gender differences of placental dysfunction in severe prematurity. BJOG. 2005; 112(2), 140–144.CrossRefGoogle ScholarPubMed
Clifton, VL. Review: sex and the human placenta: mediating differential strategies of fetal growth and survival. Placenta. 2010; 31 Suppl, S33–S39.CrossRefGoogle ScholarPubMed