title: Intrauterine tobacco smoke exposure and hyaline membrane disease amongst triplets.
abstract: We assessed the association between prenatal smoking and respiratory distress syndrome (RDS) among triplets using a population-based retrospective cohort of 12,169 triplet live births in the United States between 1995 and 1997. Analysis was conducted using the generalised estimating equation framework to adjust for intra-cluster correlations. A total of 938 cases of RDS were reported comprising 35 among smoking (7.2%) and 903 among non-smoking gravidas (7.7%). The likelihood of RDS was comparable in both smoking categories [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.65-1.32]. The risk for RDS due to smoking diminished with declining birth weight albeit non-significantly: low birth weight (OR = 0.99; 95% CI = 0.40-2.42), very low birth weight (OR = 0.85; 95% CI = 0.39-1.86), and extremely low birth weight (OR = 0.69; 95% CI = 0.30-1.58). In conclusion, among triplet neonates, smoking during pregnancy was not associated with respiratory distress syndrome.
authors.affiliation: Department of Maternal and Child Health, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. hsalihu@uab.edu
authors.forename: H M
authors.initials: HM
authors.lastname: Salihu
authors.forename: T N
authors.initials: TN
authors.lastname: McCainey
authors.forename: M H
authors.initials: MH
authors.lastname: Aliyu
authors.forename: A T
authors.initials: AT
authors.lastname: Williams
authors.forename: R A
authors.initials: RA
authors.lastname: Dimmitt
authors.forename: G R
authors.initials: GR
authors.lastname: Alexander
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006819:Hyaline Membrane Disease / Q000453:epidemiology* / Q000209:etiology; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D014310:Triplets