Maternal cigarette smoking, regular use of multivitamin/mineral supplements, and risk of fetal death: the 1988 National Maternal and Infant Health Survey.
Data from the 1988 National Maternal and Infant Health Survey were used to examine whether regular use of multivitamin/mineral supplements could modify the relation between maternal smoking and fetal death. Maternal smoking was defined as the self-reported average number of cigarettes smoked after recognition of pregnancy. Regular supplement use was defined as use of multivitamin/mineral supplements for at least 3 days per week during the 3 months before and/or after recognition of pregnancy. The sample comprises 12,465 singleton pregnancies, including 9,402 livebirths and 3,063 fetal deaths. Odds ratios were derived from logistic regression analyses after adjustment for a number of demographic and reproductive variables. Major findings are that 1) smoking increased the risk of fetal death; 2) regular supplement use either before or after recognition of pregnancy did not affect the risk of fetal death in the absence of maternal smoking; 3) odds ratios for fetal death among smoking women who regularly used supplements were generally smaller than those for women who did not regularly use supplements but who smoked a comparable number of cigarettes; and 4) a significant negative excess risk due to interaction was observed among women who regularly used supplements before recognition of pregnancy and smoked 20 or more cigarettes a day. These findings suggested that regular multivitamin/mineral supplement use might reduce the risk of fetal death 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
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Mendola
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P
D000328:Adult; D001719:Birth Certificates; D015986:Confounding Factors, Epidemiologic; D003644:Death Certificates; D004522:Educational Status; D015987:Effect Modifier, Epidemiologic; D005260:Female; D005313:Fetal Death; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017533:Marital Status; D008903:Minerals / Q000008:administration & dosage*; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014481:United States; D014815:Vitamins / Q000008:administration & dosage*
D008903:Minerals; D014815:Vitamins