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Cigarette smoking as risk factor for late fetal and early neonatal death.

https://arctichealth.org/en/permalink/ahliterature60031
Source
BMJ. 1988 Jul 23;297(6643):258-61
Publication Type
Article
Date
Jul-23-1988
Author
S. Cnattingius
B. Haglund
O. Meirik
Author Affiliation
Uppsala University Hospital, Sweden.
Source
BMJ. 1988 Jul 23;297(6643):258-61
Date
Jul-23-1988
Language
English
Publication Type
Article
Keywords
Female
Fetal Death
Humans
Infant mortality
Infant, Newborn
Maternal Age
Parity
Pregnancy
Pregnancy, Multiple
Prospective Studies
Regression Analysis
Risk factors
Smoking - adverse effects
Sweden
Abstract
Risk factors for late fetal death and early neonatal mortality were examined in a population based prospective study. Practically all Swedish births between 1983 and 1985 were included, 281,808 births in all. The overall rates of late fetal death and early neonatal mortality were 3.5 and 3.1 per 1000, respectively. About 30% of the pregnant women were recorded as being daily smokers. Logistic regression analyses showed significant relative risks for late fetal death for high maternal age (1.4), nulliparity (1.4), multiparity (greater than or equal to 2) (1.3), smoking (1.4), and multiple births (2.8). Significant relative risks for early neonatal mortality were found for multiple births (4.9) and smoking (1.2). Smokers aged under 35 faced a relative risk of late fetal death ranging from 1.1 to 1.6, while the risk for late fetal death was doubled if the mothers were aged 35 years or more and smoked. In countries like Sweden, where maternal cigarette smoking is prevalent, smoking may be the most important preventable risk factor for late fetal death.
PubMed ID
3416144 View in PubMed
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Delayed childbearing and risk of adverse perinatal outcome. A population-based study.

https://arctichealth.org/en/permalink/ahliterature59589
Source
JAMA. 1992 Aug 19;268(7):886-90
Publication Type
Article
Date
Aug-19-1992
Author
S. Cnattingius
M R Forman
H W Berendes
L. Isotalo
Author Affiliation
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Source
JAMA. 1992 Aug 19;268(7):886-90
Date
Aug-19-1992
Language
English
Publication Type
Article
Keywords
Adult
Comparative Study
Female
Fetal Death
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Maternal Age
Odds Ratio
Parity
Population Surveillance
Pregnancy
Pregnancy outcome
Regression Analysis
Risk factors
Sweden
Abstract
OBJECTIVE--To investigate the effect of advancing maternal age on pregnancy outcome among healthy nulliparous women, after adjustment for demographic characteristics, smoking, history of infertility, and other medical conditions. DESIGN--A population-based cohort study was conducted with prospectively collected data from the Swedish Medical Birth Register. PATIENTS--Nulliparous Nordic women (N = 173,715), aged 20 years and above, who delivered single births at Swedish hospitals from 1983 through 1987. OUTCOME MEASURES--Late fetal and early neonatal death rates; rates of very low birth weight (VLBW, less than 1500 g), moderately low birth weight (MLBW, 1500 through 2499 g), very preterm delivery (less than or equal to 32 weeks), moderately preterm delivery (33 through 36 weeks), and small-for-gestational-age (SGA) infants (less than -2 SDs). RESULTS--Compared with women aged 20 to 24 years, women aged 30 to 34 years had significantly higher adjusted odds ratios (ORs) of late fetal deaths (OR = 1.4); VLBW (OR = 1.2); MLBW (OR = 1.4); very preterm birth (OR = 1.2); and SGA infants (OR = 1.4). Among women aged 35 to 39 years, the adjusted OR was significantly higher for VLBW (OR = 1.9); MLBW (OR = 1.7); very preterm birth (OR = 1.7); moderately preterm birth (OR = 1.2); and SGA infants (OR = 1.7). Among women 40 years old and older, the adjusted OR was significantly higher for VLBW (OR = 1.8); MLBW (OR = 2.0); very preterm birth (OR = 1.9); moderately preterm birth (OR = 1.5); and SGA infants (OR = 1.4). CONCLUSIONS--Delayed childbearing is associated with an increased risk of poor pregnancy outcomes after adjustment for maternal complications and other risk factors.
Notes
Comment In: JAMA. 1993 Feb 10;269(6):745-6; author reply 746-78423649
Comment In: JAMA. 1993 Feb 10;269(6):746; author reply 746-78423650
Comment In: JAMA. 1993 Feb 10;269(6):746; author reply 746-78423651
PubMed ID
1640617 View in PubMed
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Effect of age, parity, and smoking on pregnancy outcome: a population-based study.

https://arctichealth.org/en/permalink/ahliterature59544
Source
Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):16-21
Publication Type
Article
Date
Jan-1993
Author
S. Cnattingius
M R Forman
H W Berendes
B I Graubard
L. Isotalo
Author Affiliation
Division of Epidemiology, Statistics and Preventive Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Source
Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):16-21
Date
Jan-1993
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Maternal Age
Odds Ratio
Parity - physiology
Pregnancy
Pregnancy outcome
Regression Analysis
Smoking - adverse effects
Sweden
Abstract
OBJECTIVES: The purpose of our study was to investigate the combined interactive effects of maternal age, parity, and smoking on pregnancy outcome. STUDY DESIGN: This was a population-based Swedish study (n = 538,829). RESULTS: Multiple logistic regression analysis showed that the smoking-related effect on the relative increase in the odds ratio of low birth weight and preterm delivery was significantly greater among multiparous patients than nulliparous; among multiparas, smoking increased the odds ratios for low birth weight and preterm delivery by 2.4 and 1.6; the corresponding relative increases in the odds ratios among nulliparas were 1.7 and 1.1, respectively. With advancing maternal age there was a smoking-related relative increase in the odds ratios for small-for-gestational-age births. Moreover, the age effect on the relative increase of low birth weight, preterm delivery, and small-for-gestational-age births was greater among nulliparas than multiparas. CONCLUSIONS: Older smokers are at an especially high risk for small-for-gestational-age births, and parous smokers are at an especially high risk for low birth weight and preterm delivery.
PubMed ID
8420320 View in PubMed
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Effects of maternal age, parity, and smoking on the risk of stillbirth.

https://arctichealth.org/en/permalink/ahliterature48467
Source
Br J Obstet Gynaecol. 1994 Apr;101(4):301-6
Publication Type
Article
Date
Apr-1994
Author
E G Raymond
S. Cnattingius
J L Kiely
Author Affiliation
Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland.
Source
Br J Obstet Gynaecol. 1994 Apr;101(4):301-6
Date
Apr-1994
Language
English
Publication Type
Article
Keywords
Abortion, Spontaneous - epidemiology - etiology
Adult
Cohort Studies
Female
Fetal Death - epidemiology - etiology
Fetal Growth Retardation - etiology
Gestational Age
Humans
Maternal Age
Odds Ratio
Parity
Population Surveillance
Pregnancy
Pregnancy, High-Risk
Regression Analysis
Risk factors
Smoking - adverse effects
Sweden - epidemiology
Abstract
OBJECTIVE: To examine the effects of advanced maternal age, nulliparity, and smoking on risk of stillbirth as gestation advances, and to explore possible clinical mediators of these effects. DESIGN: A population based cohort study. SETTING: Sweden, 1983 to 1989. SUBJECTS: All singleton pregnancies of 28 weeks gestation or greater in Nordic citizens at least 20 years old (n = 638,242). MAIN OUTCOME MEASURES: Crude and adjusted risks of stillbirth; gestational age specific risks of stillbirth. RESULTS: Older women (35 years or older), smokers, and nulliparas had elevated risks of stillbirth. The elevated stillbirth risk in smokers was eliminated when women with intrauterine growth retardation, placental abruption, and placenta previa were excluded from the analysis. However, the higher risks in older women and nulliparas persisted even when the analysis excluded women with hypertension, diabetes, placental complications, or growth retardation. Over the course of the third trimester, the age related risk of stillbirth increased, the smoking related risk decreased, and the higher risk in nulliparas showed no clear trend with gestational age. CONCLUSIONS: The association between smoking and stillbirth is explained entirely by the higher incidence of growth retardation and placental complications in smokers. The clinical mediators of the associations of maternal age and parity with stillbirth remain unexplained. Gestational age is an important modifier of the effects of advanced maternal age and smoking on stillbirth risk.
PubMed ID
8199075 View in PubMed
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Factors associated with birth weight in Sweden: the study of men born in 1913.

https://arctichealth.org/en/permalink/ahliterature64364
Source
J Epidemiol Community Health. 1997 Feb;51(1):19-23
Publication Type
Article
Date
Feb-1997
Author
M. Eriksson
S. Cnattingius
K. Svärdsudd
G. Tibblin
Author Affiliation
University of Uppsala, Clinical Epidemiology Unit, Department of Family Medicine, Sweden.
Source
J Epidemiol Community Health. 1997 Feb;51(1):19-23
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Birth weight
Cohort Studies
Female
Gestational Age
Humans
Male
Maternal Age
Parity
Pregnancy
Pregnancy Complications
Proteinuria
Regression Analysis
Research Support, Non-U.S. Gov't
Retrospective Studies
Rural Health
Socioeconomic Factors
Sweden
Urban health
Abstract
STUDY OBJECTIVE: To analyse factors associated with birth weight and to evaluate the validity of obstetrical data. DESIGN: Obstetrical data were retrieved for singleton men born in 1913 and living in Gothenburg, Sweden in 1963. Information on birth weight, maternal age, marital status, parity, social class, proteinuria, gestational age, and place of birth (home or hospital) was obtained from these birth records. SETTING: Sweden. PARTICIPANTS: Fifty year old men living in Gothenburg, Sweden, in 1963. MAIN RESULTS: Obstetrical records were obtained for 524 men (65%). Place of birth, gestational age, maternal age, parity, proteinuria, and marital status were all significantly correlated to birth weight. In multivariate analyses, place of birth, gestational age, parity, and proteinuria influenced birth weight. There was a substantial difference in mean birth weight between hospital deliveries (3352 g) and home deliveries (3817 g), which could be explained only partly by sociodemographic variables. Birth weight increased with parity and gestational age in home delivered babies as well as those delivered in a hospital. CONCLUSIONS: The validity of obstetrical records from 1913 was good. The place of birth (home or hospital) is strongly associated with birth weight and may be a confounding factor in studies of the implications of birth weight for future risk of disease or death.
PubMed ID
9135783 View in PubMed
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Maternal age modifies the effect of maternal smoking on intrauterine growth retardation but not on late fetal death and placental abruption.

https://arctichealth.org/en/permalink/ahliterature64361
Source
Am J Epidemiol. 1997 Feb 15;145(4):319-23
Publication Type
Article
Date
Feb-15-1997
Author
S. Cnattingius
Author Affiliation
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
Source
Am J Epidemiol. 1997 Feb 15;145(4):319-23
Date
Feb-15-1997
Language
English
Publication Type
Article
Keywords
Abruptio Placentae - etiology
Adolescent
Adult
Age Factors
Birth Certificates
Case-Control Studies
Female
Fetal Death - etiology
Fetal Growth Retardation - etiology
Humans
Maternal Age
Pregnancy
Pregnancy Complications
Registries
Regression Analysis
Smoking - adverse effects
Sweden
Abstract
To investigate whether the effect modification of smoking by maternal age previously reported for small for gestational age births was also obtained for late fetal death and placental abruption, the author analyzed single births in Sweden (n = 1,057,711) from 1983 to 1992. An effect modification of smoking by maternal age was obtained only with regard to fetal growth: Compared with nonsmokers aged 40-44 years, the risk of small for gestational age births among women smoking at east 10 cigarettes per day in the same age group was 4.5, whereas the corresponding risk increase among teenagers was only 2.0. The present results support the hypothesis that smoking actually influences fetal growth more among older smokers.
PubMed ID
9054235 View in PubMed
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Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth.

https://arctichealth.org/en/permalink/ahliterature63847
Source
Am J Obstet Gynecol. 2001 Feb;184(3):463-9
Publication Type
Article
Date
Feb-2001
Author
O. Stephansson
P W Dickman
A. Johansson
S. Cnattingius
Author Affiliation
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Source
Am J Obstet Gynecol. 2001 Feb;184(3):463-9
Date
Feb-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Body mass index
Case-Control Studies
Employment
Female
Fetal Death - epidemiology - etiology
Humans
Linear Models
Obesity - complications
Pregnancy
Prospective Studies
Regression Analysis
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Weight Gain
Abstract
OBJECTIVE: This study investigated whether the risk of antepartum stillbirth increases with body mass index during early pregnancy and also investigated the association between weight gain during pregnancy and the risk of antepartum stillbirth.Study Design: This population-based case-control study included 649 women with antepartum stillbirths and 690 control subjects among Swedish nulliparous women. RESULTS: Compared with lean mothers (body mass index or = 30.0 kg/m2) odds ratio, 2.1 (95% confidence interval, 1.2-3.6). For term antepartum death corresponding risks were even higher, with odds ratios of 1.6 (95% confidence interval, 0.9-2.6) for normal weight, 2.7 (95% confidence interval, 1.5-5.0) for overweight, and 2.8 (95% confidence interval, 1.3-6.0) for obese women, respectively. Maternal weight gain during pregnancy was not associated with risk of antepartum stillbirth. CONCLUSION: Maternal overweight condition increased the risk of antepartum stillbirth, especially term antepartum stillbirth, whereas weight gain during pregnancy was not associated with risk.
PubMed ID
11228504 View in PubMed
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The paradoxical effect of smoking in preeclamptic pregnancies: smoking reduces the incidence but increases the rates of perinatal mortality, abruptio placentae, and intrauterine growth restriction.

https://arctichealth.org/en/permalink/ahliterature59069
Source
Am J Obstet Gynecol. 1997 Jul;177(1):156-61
Publication Type
Article
Date
Jul-1997
Author
S. Cnattingius
J L Mills
J. Yuen
O. Eriksson
H. Salonen
Author Affiliation
Department of Cancer Epidemiology, Uppsala University, Sweden.
Source
Am J Obstet Gynecol. 1997 Jul;177(1):156-61
Date
Jul-1997
Language
English
Publication Type
Article
Keywords
Abruptio Placentae - epidemiology - physiopathology
Adolescent
Adult
Female
Fetal Growth Retardation - epidemiology - physiopathology
Humans
Incidence
Infant mortality
Infant, Newborn
Infant, Small for Gestational Age
Maternal Welfare
Pre-Eclampsia - epidemiology - physiopathology - prevention & control
Pregnancy
Pregnancy outcome
Prospective Studies
Registries
Regression Analysis
Risk factors
Smoking - adverse effects
Sweden - epidemiology
Abstract
OBJECTIVES: Smoking is associated with a reduced risk of preeclampsia, but what is the outcome of pregnancy when preeclampsia develops in women who smoke? STUDY DESIGN: Single births in Sweden from 1987 through 1993 to nulliparous women aged 15 to 34 years (N = 317,652) were included. Poisson regression analyses were used to calculate adjusted relative risks and rates of adverse pregnancy outcomes. RESULTS: Maternal smoking was associated with significantly reduced risks of mild and severe preeclampsia (relative risks = 0.6 and 0.5, respectively). In pregnancies with severe preeclampsia, smoking at least 10 cigarettes per day was associated with increased rates of perinatal mortality (from 24 to 36 per 1000), abruptio placentae (from 31 to 67 per 1000), and being small for gestational age (from 28% to 68%), whereas the corresponding smoking-related increases in rates in nonhypertensive pregnancies were considerably less. CONCLUSIONS: Smokers in whom preeclampsia develops have very high risks of perinatal mortality, abruptio placentae, and small-for-gestational-age infants.
PubMed ID
9240600 View in PubMed
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Polychlorinated biphenyl congeners as markers of toxic equivalents of polychlorinated biphenyls, dibenzo-p-dioxins and dibenzofurans in breast milk.

https://arctichealth.org/en/permalink/ahliterature194036
Source
Environ Res. 2001 Jul;86(3):217-28
Publication Type
Article
Date
Jul-2001
Author
A W Glynn
S. Atuma
M. Aune
P O Darnerud
S. Cnattingius
Author Affiliation
Swedish National Food Administration, Uppsala, SE-751 26, Sweden. glwi@slv.se
Source
Environ Res. 2001 Jul;86(3):217-28
Date
Jul-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Benzofurans - analysis
Biological Markers - analysis
Dioxins - analysis
Female
Humans
Milk, human - chemistry
Multivariate Analysis
Polychlorinated biphenyls - analysis
Reference Values
Regression Analysis
Reproducibility of Results
Sweden
Abstract
In breast milk, concentrations of polychlorinated biphenyls (PCBs) are higher than those of polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs), making PCB analyses less time-consuming and expensive. We searched for PCB "markers" of PCDD/DF concentrations, by studying associations between concentrations of PCB and PCDD/DFs (expressed as toxic equivalents, TEQs) in breast milk from 27 women (primiparas, 22-35 years). These women donated breast milk in 1996-1999 together with 183 other primiparas from Uppsala County, Sweden. Regression analyses showed that both dioxin-like and non-dioxin-like penta- to hepta-chlorinated PCBs could be used as markers of TEQ concentrations in this group of women, in some cases after age adjustment of the regressions. The strong positive association between concentrations of dioxin-like PCB/DD/DFs and non-dioxin-like PCBs will in future epidemiological studies make it difficult to separate Ah receptor-dependent effects from non-Ah receptor-dependent effects. With the use of regression equations and concentrations in breast milk samples collected in 1994, TEQ concentrations were estimated in the 1994 samples. Comparisons between estimated and measured concentrations indicated that associations between concentrations of marker substances and TEQs should be determined separately within each study population, in order to obtain reliable TEQ exposure assessments from PCB markers.
PubMed ID
11453672 View in PubMed
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Prenatal and neonatal risk factors for childhood myeloid leukemia.

https://arctichealth.org/en/permalink/ahliterature23166
Source
Cancer Epidemiol Biomarkers Prev. 1995 Jul-Aug;4(5):441-5
Publication Type
Article
Author
S. Cnattingius
M. Zack
A. Ekbom
J. Gunnarskog
M. Linet
H O Adami
Author Affiliation
Department of Obstetrics and Gynaecology, University Hospital, Uppsala University, Sweden.
Source
Cancer Epidemiol Biomarkers Prev. 1995 Jul-Aug;4(5):441-5
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Case-Control Studies
Child
Child, Preschool
Confidence Intervals
Down Syndrome - complications - epidemiology
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Jaundice, Neonatal - complications - epidemiology
Leukemia, Myeloid - epidemiology - etiology
Male
Maternal Age
Odds Ratio
Registries
Regression Analysis
Retrospective Studies
Risk factors
Sweden - epidemiology
Abstract
Information about the etiology of childhood myeloid leukemia is limited. A population-based nested case-control study of prenatal and neonatal risk factors for childhood myeloid leukemia was performed with the use of the Swedish National Cancer Register and the Swedish Birth Register. A total of 98 cases of myeloid leukemia were identified in successive birth cohorts from 1973 through 1989. From the Birth Register, five controls were matched to each case. Fourteen of the 98 cases with myeloid leukemia and none of the controls had Down syndrome [odds ratio (OR) = infinity; 95% confidence interval (CI) = 21.0-infinity]. The risk for myeloid leukemia also increased among children who had physiological jaundice (OR = 2.5; 95% CI = 1.2-5.0; children who had been treated with phototherapy (OR = 7.5; 95% CI = 1.8-31.9); or who had been treated in an incubator (OR = 3.5; 95% CI = 1.2-10.2). Excluding cases with Down syndrome, however, decreased these risks, so that their 95% lower confidence interval included the no-effect value. Maternal age
PubMed ID
7549797 View in PubMed
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13 records – page 1 of 2.