2010/03/16 by S. Ananth Karumanchi, Richard J. Levine · 2 citations
Medicine · #Birth, Development, and Health #Gestational Diabetes Research and Management #Pregnancy and preeclampsia studies
paper · pdf · doi:10.1161/hypertensionaha.109.148973
openalex publication_date 2010/03/16 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
A lthough smoking during pregnancy may lead to many adverse effects, such as fetal growth restriction, placental abruption, stillbirth, and preterm labor, smoking is the only environmental exposure known to consistently reduce the risk of preeclampsia and gestational hypertension. The article by Wikstro m et al 2 is a major step forward in understanding this protective effect. Using data from the Swedish Medical Birth Register in a large epidemiological study of 600 000 Nordic women, the authors conclude that use of Swedish snuff, a smokeless tobacco, did not reduce the risk of preeclampsia and gestational hypertension but that tobacco, when smoked, did. They infer that combustion products of tobacco, such as carbon monoxide (CO), protect against preeclampsia but that constituents of tobacco, such as nicotine, do not. The data strengthen and extend results of a previous smaller study using the Swedish Medical Birth Register, which had reported a similar association. Of considerable interest, using data from women who changed their tobacco habits at gestational weeks 30 to 32 from those reported at the first antenatal visit (usually before 15 weeks of gestation), Wikstro m et al 2 found that women who had reported smoking at the first antenatal visit but no use of tobacco at 30 to 32 weeks did not have reduced risk of preeclampsia or gestational hypertension compared with tobacco nonusers, whereas women who reported no use of tobacco at the first antenatal visit but smoking at 30 to 32 weeks did. This implies that smoking during the second half of pregnancy is necessary for reducing the risk of preeclampsia or gestational hypertension.