Category: Hypertension
Poster Session IV
To explore the relationship between smoking status, pre-pregnancy body-mass index (BMI), gestational weight gain, and preeclampsia.
Study Design: A cross-sectional analysis was performed utilizing data on singleton livebirths (³20 weeks’ gestation) in the US (2015-2020). We examined pregnancy-associated hypertension (hereto referred as preeclampsia) in relation to maternal smoking (categorized as non-smoker, quit smoking with pregnancy, and persistent smoker), pre-pregnancy BMI and gestational weight gain. Associations were expressed as rate ratios (with 95% confidence interval), derived from Poisson regression models with robust variance, and adjusted for potential confounders. Clinically significant outcomes of smoking throughout pregnancy were evaluated.
Results: Of the 22,191,568 women who delivered a singleton livebirth, preeclampsia rates among non-smoker, quit smoking, and persistent smoker were 6.8%, 8.6% and 7.0%, respectively. Women who quit smoking early in pregnancy had higher rates of preeclampsia in all BMI classes compared to non-smokers and persistent smokers (Table 1). Within each BMI class, the risk ratio of preeclampsia was higher for women who quit smoking than for non-smokers, especially evident with excessive gestational weight gain. There was an almost six-fold increase in the rate of stillbirth for persistent smokers (2.3%) compared to quit smoking (0.4%) and non-smoker (0.4%).
Conclusion:
Quitting smoking early in pregnancy is associated with an increased rate of preeclampsia, regardless of BMI or gestational weight gain. Gestational weight gain was highest in people who quit smoking early in pregnancy, demonstrating that women who quit smoking early in pregnancy were more likely to gain excessive weight and develop preeclampsia. Although quitting smoking early in pregnancy may significantly increase a woman’s risk of preeclampsia, it does not significantly impact the mean gestational age at delivery, neonatal birthweight, and it significantly reduces the risk of stillbirth compared to persistent smokers.
Morgan C. Dunn, MD (she/her/hers)
Resident
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Cande V. Ananth, MPH, PhD
Professor and Vice Chair for Academic Affairs, Department of Obstetrics, Gynecology, and Reproductive Sciences
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Todd J. Rosen, MD
Robert Wood Johnson University Hospital
New Brunswick, New Jersey, United States