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  • 1
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives To evaluate the effect of specific education of midwives on stopping smoking in pregnant women and to determine the effect of this programme on pregnancy outcome.Design A prospective intervention study.Setting Department of Gynaecology and Obstetrics, Aarhus University Hospital, Denmark.Population and methods A group of midwives (9 out of 54) was taught the effects of smoking during pregnancy and instructed in various methods of educating women to stop smoking. All pregnant women who attended antenatal care from October 1994 to September 1995 were either in the intervention group (n = 527) or the control group (n = 2629). Pregnant women attending the specifically educated midwives were considered to be the intervention group. They were given individual advice about stopping smoking at the first antenatal visit at about 16 weeks of gestation and a leaflet on smoking and pregnancy.Results At the first antenatal visit at about 16 weeks of gestation, 22% of the pregnant women smoked. Between the first visit and the routine visit at 30 weeks of gestation 51 (2%) stopped smoking and 56 (2%) started smoking. No differences were found between the intervention group and the control group in the rate of stopping smoking, validated by cotinine measurements. Mean birthweight, mean gestational age and the proportion of preterm birth in the two groups were similar.Conclusion Education of midwives and integration of advice about smoking cessation at a low cost in routine antenatal care failed to affect smoking habits among pregnant women.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children.Design  Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark.Setting  Aarhus University Hospital, Denmark, 1989–1996.Population  A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses.Methods  Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI 〈18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2) and obese (BMI 30.0 kg/m2 or more).Main outcome measures  Stillbirth and neonatal death and causes of death.Results  Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5–5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2–5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth or neonatal death was found among underweight or overweight women. Adjustment for maternal cigarette smoking, alcohol and caffeine intake, maternal age, height, parity, gender of the child, years of schooling, working status and cohabitation with partner did not change the conclusions, nor did exclusion of women with hypertensive disorders or diabetes mellitus. No single cause of death explained the higher mortality in children of obese women, but more stillbirths were caused by unexplained intrauterine death and fetoplacental dysfunction among obese women compared with normal weight women.Conclusion  Maternal obesity more than doubled the risk of stillbirth and neonatal death in our study. The present and other studies linking maternal obesity to an increased risk of severe adverse pregnancy outcomes emphasise the need for public interventions to prevent obesity in young women.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 103 (1996), S. 0 
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To evaluate the association between smoking during pregnancy and preterm birth.Design A follow up study.Setting Department of Gynaecology and Obstetrics, Aarhus University Hospital, Denmark.Participants Four thousand one hundred and eleven nulliparous women with singleton pregnancies who returned questionnaires about smoking habits at 16 weeks of gestation.Results The overall rate of preterm delivery was 4.3 %. Smokers had a 40 % higher risk of preterm birth compared with nonsmokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, prepregnancy weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and nonsmokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared with nonsmokers. Furthermore, among women with a high intake of caffeine a dose-response relationship was found; women smoking one to five cigarettes per day had no increased risk of preterm birth compared with nonsmokers with the same intake of caffeine, women smoking six to ten cigarettes per day had almost three times higher risk of preterm birth, and women smoking more than 10 cigarettes per day had almost five times higher risk of preterm birth compared with nonsmokers with the same intake of caffeine.Conclusions Smoking increases the risk of preterm birth. The association between smoking and preterm birth was only present among women with a high intake of caffeine. However, whether smoking alone influences the risk of preterm birth among heavy consumers of caffeine needs further investigation.
    Type of Medium: Electronic Resource
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