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The complex relationship between smoking in pregnancy and very preterm delivery (2004)

Burguet, Antoine ; Kaminski, Monique ; Abraham-Lerat, Laurence ; [et al.]

Oxford, UK and Malden, USA : Blackwell Science Ltd

BJOG 111 (2004), S. 0

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ISSN: 1471-0528

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: Objective To assess the relationship between cigarette smoking during pregnancy and very preterm births, according to the main mechanisms of preterm birth.Design Case–control study (the French Epipage study).Setting Regionally defined population of births in France.Population Eight hundred and sixty-four very preterm live-born singletons (between 27 and 32 completed weeks of gestation) and 567 unmatched full-term controls.Methods Data from the French Epipage study were analysed using a polytomous logistic regression model to control for social and demographic characteristics, pre-pregnancy body mass index and obstetric history. The main mechanisms of preterm delivery were classified as gestational hypertension, antepartum haemorrhage, premature rupture of membranes, spontaneous preterm labour and other miscellaneous mechanisms.Main outcome measures Odds ratios for very preterm birth for low to moderate (1–9 cigarettes/day) and heavy (≥10 cigarettes/day) maternal smoking in pregnancy, estimated according to the main mechanisms leading to preterm birth.Results Smokers were more likely to give birth to very preterm infants than non-smokers [adjusted odds ratio (aOR) 1.7, 95% confidence interval (CI) 1.3–2.2]. Heavy smoking significantly reduced the risk of very preterm birth due to gestational hypertension (aOR 0.5, 95% CI 0.3–1.0), whereas both low to moderate and heavy smoking increased the risk of very preterm birth due to all other mechanisms (aOR between 1.6 and 2.8).Conclusion These data from the Epipage study show that maternal smoking during pregnancy is a risk factor for very preterm birth. The impact of maternal smoking on very preterm birth appears to be complex: it lowers the risk of very preterm birth due to gestational hypertension, but increases the risk of very preterm birth due to other mechanisms. These findings might explain why maternal smoking is more closely related to preterm birth among multiparous women than among nulliparous women.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1046/j.1471-0528.2003.00037.x

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Trisomy 11p15 and Beckwith-Wiedemann syndrome. A report of two cases (1984)

Turleau, Catherine ; Grouchy, Jean ; Chavin-Colin, Françoise ; [et al.]

Springer

Human genetics 〈Berlin〉 67 (1984), S. 219-221

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ISSN: 1432-1203

Source: Springer Online Journal Archives 1860-2000

Topics: Biology , Medicine

Notes: Summary Two patients with trisomy 11p15 and features of Beckwith-Wiedemann syndrome are reported. The first is a female infant with gigantism, macroglossia, abdominal hypotonia with umbilical hernia, moderate mental retardation, malformative uropathy, and atrial septal defect. Trisomy 11p15 was due to de novo duplication. The second patient was a stillborn (32–33 weeks pregnancy) with an abnormal tongue, posterior diaphragmatic eventration, inner organ congestion mainly of the adrenals. Trisomy 11p15 was due to a t(4;11)(q33;p14)pat. The association of trisomy 11p15 and Beckwith-Wiedemann syndrome is discussed with regard to cytogenetic data and the gene content of 11p, notably the genes coding for insulin and predisposition to Wilms tumour.