Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy.

Publisher: Hindawi Limited Country of Publication: England NLM ID: 101605237 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6753 (Electronic) NLM ISO Abbreviation: J Diabetes Res Subsets: MEDLINE

Publication: <2019>-: London, United Kingdom : Hindawi Limited
Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2013]-

Congenital Abnormalities/*etiology ; Diabetes Mellitus/*physiopathology ; Maternal Exposure/*adverse effects ; Pregnancy in Diabetics/*physiopathology ; Premature Birth/*etiology ; Smoking/*adverse effects; Adult ; Cohort Studies ; Female ; Humans ; Infant, Newborn ; Italy ; Pregnancy ; Pregnancy Outcome ; Prevalence ; Registries ; Risk Factors ; Tobacco Smoking

Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007-2010 matched 1 : 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other's effect on preterm birth and congenital anomalies.

Diabetes Res Clin Pract. 2017 Jan;123:106-111. (PMID: 28002751)
Hum Reprod Update. 2011 Sep-Oct;17(5):589-604. (PMID: 21747128)
Eur J Pediatr. 2010 Jun;169(6):741-8. (PMID: 19953266)
Acta Diabetol. 2010 Sep;47(3):187-92. (PMID: 20502927)
Am J Obstet Gynecol. 1989 Jul;161(1):106-11. (PMID: 2665491)
Chronic Dis Inj Can. 2012 Jun;32(3):113-20. (PMID: 22762897)
PLoS One. 2015 Dec 29;10(12):e0145873. (PMID: 26714032)
Cardiovasc Diabetol. 2016 Nov 24;15(1):158. (PMID: 27881170)
Environ Health Prev Med. 2012 Jul;17(4):285-91. (PMID: 22065307)
Paediatr Perinat Epidemiol. 2009 Sep;23(5):446-53. (PMID: 19689495)
J Epidemiol Community Health. 2014 Feb;68(2):159-64. (PMID: 24158704)
Nicotine Tob Res. 2009 Jan;11(1):12-24. (PMID: 19246437)
Environ Res. 2017 Apr;154:304-310. (PMID: 28142053)
J Clin Endocrinol Metab. 2009 Nov;94(11):4284-91. (PMID: 19808847)
Eur J Public Health. 2017 Feb 1;27(1):135-139. (PMID: 28177439)
Eur J Epidemiol. 2014 Jun;29(6):411-8. (PMID: 24861339)
Diabetes Res Clin Pract. 2014 Jan;103(1):79-87. (PMID: 24369984)
Am J Obstet Gynecol. 2000 Dec;183(6):1520-4. (PMID: 11120521)
Eur J Epidemiol. 2005;20(7):575-9. (PMID: 16119429)
Diabetes Metab. 2004 Jun;30(3):261-8. (PMID: 15223978)
Eur J Epidemiol. 2011 Jun;26(6):433-8. (PMID: 21344323)
Am J Epidemiol. 2016 Jan 15;183(2):122-9. (PMID: 26656480)
Birth Defects Res A Clin Mol Teratol. 2012 Mar;94(3):134-40. (PMID: 22371321)
J Epidemiol Community Health. 2009 Sep;63(9):681-2. (PMID: 19679713)
Birth Defects Res A Clin Mol Teratol. 2011 Mar;91 Suppl 1:S2-15. (PMID: 21384531)
Am J Obstet Gynecol. 2005 Jul;193(1):125-34. (PMID: 16021070)
Eur J Epidemiol. 2012 Apr;27(4):297-304. (PMID: 22430122)
Epidemiol Prev. 2013 Mar-Jun;37(2-3):145-52. (PMID: 23851244)
Obstet Gynecol. 1988 Aug;72(2):175-80. (PMID: 3393360)
BMC Pregnancy Childbirth. 2006 Oct 30;6:30. (PMID: 17074087)
Diabetes Care. 2014 Jun;37(6):1590-6. (PMID: 24705609)
Diabet Med. 2013 Dec;30(12):1442-8. (PMID: 23909859)
BJOG. 2008 Mar;115(4):445-52. (PMID: 18271881)
BMJ Open. 2015 Jul 29;5(7):e006988. (PMID: 26224014)
Am J Epidemiol. 1980 Oct;112(4):467-70. (PMID: 7424895)
Am J Prev Med. 2015 Feb;48(2):195-204. (PMID: 25326416)
Ital J Pediatr. 2014 Nov 23;40:91. (PMID: 25416843)

Date Created: 20180728 Date Completed: 20181211 Latest Revision: 20230926

20240829

PMC6046136

10.1155/2018/2782741

30050951