Smoking worsens outcomes related to preeclampsia

Although cigarette smoking decreases slightly the risk for developing preeclampsia, a new study reported by Canadian researchers suggests that smokers who do develop the condition are at higher risk for the complications associated with the disorder: preterm delivery, low birth weight, and stillbirth.

Using a database with information on more than 300,000 births between 2004 and 2006, the researchers found that women who smoked during pregnancy had a slightly lower rate of preeclampsia-1.2% versus 1.5% in nonsmokers-but that the incidence of adverse pregnancy outcomes was more than twice as high among women with preeclampsia who smoked as among women without preeclampsia who did not smoke.

Compared with nonsmokers without preeclampsia, smokers with preeclampsia had ORs of 3.4 for having a small-for-gestational-age baby, 5.77 for preterm birth, 5.44 for very preterm birth, 6.16 for abruption, 3.11 for an Apgar score of less than 4 at 5 minutes, and 3.39 for stillbirth.

Miller EC, Cao H, Wen SW, Yang Q, Lafleche J, Walker M. The risk of adverse pregnancy outcomes is increased in preeclamptic women who smoke compared with nonpreeclamptic women who do not smoke. Am J Obstet Gynecol. 2010. Epub ahead of print.