title: Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes.
abstract: OBJECTIVE
  To determine the effects of smoking on pre-eclampsia in an inner-city, predominantly African-American prenatal population.
  
  
  METHODS
  We performed a retrospective cohort study of all primigravidas who delivered singletons in our institution between 1980 and 1989. The study population consisted of 1862 smokers and 16,508 non-smokers. Univariate analysis and multiple logistic regression were used to identify relationships between smoking and adverse outcomes.
  
  
  RESULTS
  The pre-eclampsia rate was significantly lower among smokers (11.3% vs. 13.0%, OR 0.85, 95% CI 0.73-0.99). Smokers with pre-eclampsia had higher rates of infants with low birth weight (OR 1.44, 95% CI 1.26-1.65) and very low birth weight (OR 1.85, 95% Cl 1.55-2.20) and higher rates of placental abruption (OR 3.49, 95% CI 1.65-7.28) compared to non-smoking pre-eclamptics. This relationship persisted after correction for age, race, chronic hypertension and pre-eclampsia as confounding variables.
  
  
  CONCLUSIONS
  Cigarette smoking was associated with a lower rate of pre-eclampsia among primigravidas independently of other maternal factors. Perinatal outcomes were significantly worsened among pre-eclamptics who smoked.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University School of Medicine and Maternal Fetal Medicine Center, Woman's Hospital of Baton Rouge, Louisiana 70815, USA. mgnewman1@home.com
authors.forename: M G
authors.initials: MG
authors.lastname: Newman
authors.forename: M K
authors.initials: MK
authors.lastname: Lindsay
authors.forename: W
authors.initials: W
authors.lastname: Graves
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D017533:Marital Status; D008423:Maternal Age; D008499:Medical Records; D010922:Placenta Diseases / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D014505:Urban Population