title: The combined effect of maternal smoking and obesity on the risk of preeclampsia.
abstract: OBJECTIVE
  Cigarette smoking during pregnancy is associated with a lower risk of preeclampsia, whereas obesity increases the risk of preeclampsia. We sought to assess the combined effect of smoking and obesity on the risk of preeclampsia.
  
  
  METHODS
  We conducted a population-based cohort study of 129,674 women who delivered singleton infants during 2000-2001. Data for cigarette use, pre-pregnancy body mass index (BMI), preeclampsia, and potential confounders were obtained from birth certificate files. Mantel-Haenszel stratified analysis and logistic regression were used to analyze the data.
  
  
  RESULTS
  The preeclampsia risk was 3.1, 4.5, 7.6 and 8.8% for normal weight (BMI 18.5-24.9), overweight (25.0-29.9), obese (30.0-39.9) and morbidly obese (>or=40.0 kg/m2) women, respectively, who smoked cigarettes while pregnant. The preeclampsia risk was 3.9, 6.2, 9.0 and 12.3% for the same groups of women, respectively, who did not smoke during their pregnancy. Compared to non-smokers, the relative risk of preeclampsia for women who smoked cigarettes was 0.78 (95% confidence interval 0.73-0.83) before and after adjusting for pre-pregnancy BMI and other factors associated with preeclampsia.
  
  
  CONCLUSIONS
  The risk of preeclampsia is lower for women who smoke cigarettes while pregnant regardless of their pre-pregnancy BMI.
authors.affiliation: Department of Community Health, Saint Louis University, St. Louis, MO 63110, USA.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Stone
authors.forename: Ousmane
authors.initials: O
authors.lastname: Diallo
authors.forename: Jaye
authors.initials: J
authors.lastname: Shyken
authors.forename: Terry
authors.initials: T
authors.lastname: Leet
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications*; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking