Adverse pregnancy outcomes in snuff users.
OBJECTIVE
The purpose of the study was to evaluate the effects of smokeless tobacco use during pregnancy.


METHODS
We examined birth weight, preterm delivery, and preeclampsia in women who were delivered of singleton, live-born infants in Sweden from 1999 through 2000. For each snuff user, 10 cigarette smokers and 10 tobacco nonusers were selected randomly.


RESULTS
After exclusions, 789 snuff users, 11,240 smokers, and 11,495 nonusers remained. Compared with nonusers, adjusted mean birth weight was reduced in snuff users by 39 g (95% CI, 6-72 g) and in smokers by 190 g (95% CI, 178-202 g). Preterm delivery was increased in snuff users and smokers (adjusted odds ratios, 1.98 [95% CI, 1.46-2.68] and 1.57 [95% CI, 1.38-1.80], respectively). Preeclampsia was reduced in smokers (adjusted odds ratio, 0.63; 95% CI, 0.53-0.75) but increased in snuff users (adjusted odds ratio, 1.58; 95% CI, 1.09-2.27).


CONCLUSIONS
Snuff use was associated with increased risk of preterm delivery and preeclampsia. Snuff does not appear to be a safe alternative to cigarettes during pregnancy.
England
Lucinda J
LJ
Division of Epidemiology, Statistics, and Prevention Research, Department of Health and Human Services, National Institute of Child Health and Human Development, Bethesda, MD 20892, USA. englandl@mail.nih.gov
Levine
Richard J
RJ
Mills
James L
JL
Klebanoff
Mark A
MA
Yu
Kai F
KF
Cnattingius
Sven
S
D001724:Birth Weight; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014030:Tobacco, Smokeless / Q000009:adverse effects*