The impact of tobacco smoking on perinatal outcome among ... - Nature

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Nov 12, 2009 - odds ratios (OR) were reported with 95% confidence intervals (CI). ... its association with type II DM, tobacco smoking as a risk factor for.
Journal of Perinatology (2010) 30, 319–323 r 2010 Nature Publishing Group All rights reserved. 0743-8346/10 $32 www.nature.com/jp

ORIGINAL ARTICLE

The impact of tobacco smoking on perinatal outcome among patients with gestational diabetes KR Contreras, MA Kominiarek and TW Zollinger Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA

Objective: To determine the effects of tobacco use on perinatal outcomes among patients with gestational diabetes (GDM).

Study Design: This was a retrospective cohort study of singleton pregnancies with GDM and live births from 2003 to 2006. The primary outcome, large for gestational age (LGA) infants, was compared between smoking and nonsmoking groups. Secondary outcomes included cesarean deliveries, shoulder dystocia, birth trauma, peripartum complications, macrosomia, 5-min Apgar score p3, birth defects, and neonatal intensive care unit (NICU) admissions. w2 and Student t-tests compared the two groups; a P-value 200 mg per 100 ml or an abnormal 100-g 3 h oral glucose tolerance test based on the Carpenter and Coustan criteria confirmed GDM. The primary outcome, the proportion of LGA infants (birth weight >90th% according to a standard infant growth chart),7 was compared between the smokers and nonsmokers. A birth weight >4000 g defined macrosomia. The following secondary outcomes were compared between the two groups: labor induction, delivery route, cesarean indication, presence of perineal laceration, estimated blood loss, and shoulder dystocia. Postpartum hemorrhage was as an estimated blood loss >500 or >1000 ml for vaginal or cesarean deliveries, respectively. The following neonatal outcomes were also comparedFpreterm delivery (18 kg weight gain

12±7 138 (19)

14±9 38 (31)

0.024 0.004

13 (2) 24 (3)

12 (9) 33 (25)