Can regular multivitamin/mineral supplementation modify the relation between maternal smoking and select adverse birth outcomes?
OBJECTIVE
The purpose of this study was to examine whether or not regular multivitamin/mineral supplementation can modify the relation between maternal smoking and preterm birth (gestational age < 37 weeks), very-low-birthweight (VLBW) (< 1500 g), moderately-low-birthweight (MLBW) (< 2499 g), or small-for-gestational-age (SGA) (< 10th percentile of birth weight for gestational age).


METHODS
Live birth data from the 1988 National Maternal and Infant Health Survey (NMIHS) were used for the analysis. Maternal smoking referred to self-reported average number of cigarettes smoked after recognition of pregnancy, while regular multivitamin/mineral supplementation referred to use of multivitamin/mineral supplements for at least three days per week during the three months before and/or after recognition of pregnancy. Sample sizes included 9402 singleton infants for the analysis of preterm birth, 9395 for very or moderately low birthweight, and 9363 for small-for-gestational-age. Odds ratios were derived from logistic regression analyses after adjusting for a number of demographic and reproductive variables.


RESULTS
Major results include: 1) increased risks for the adverse outcomes studied were observed among smoking women; 2) no effect of regular multivitamin/mineral supplementation in the absence of maternal smoking was revealed; and 3) relative excess risks due to interaction at different smoking levels and overall interactions between smoking and supplementation were not observed.


CONCLUSIONS
These results suggest that regular multivitamin/mineral supplementation does not minimize the adverse effects associated with maternal smoking.
Wu
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T
Department of Social and Preventive Medicine, School of Medicine and Biomedical Science, State University of New York at Buffalo 14214, USA.
Buck
G
G
Mendola
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P
D000328:Adult; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight; D008903:Minerals; D009752:Nutritional Status; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012907:Smoking / Q000009:adverse effects*; D014815:Vitamins
D008903:Minerals; D014815:Vitamins