title: Maternal smokeless tobacco use in Alaska Native women and singleton infant birth size.
abstract: OBJECTIVE
  To examine the effects of maternal prenatal smokeless tobacco use on infant birth size.
  
  
  METHODS
  A retrospective medical record review of 502 randomly selected deliveries.
  
  
  METHODS
  Singleton deliveries to Alaska Native women residing in a defined geographical region in western Alaska, 1997-2005.
  
  
  METHODS
  A regional medical center's electronic records were used to identify singleton deliveries. Data on maternal tobacco exposure and pregnancy outcomes were abstracted from medical records. Logistic models were used to estimate adjusted mean birthweight, length and head circumference for deliveries to women who used no tobacco (n=121), used smokeless tobacco (n=237) or smoked cigarettes (n=59). Differences in mean birthweight, length and head circumference, 95% confidence intervals and p-values were calculated using non-users as the reference group.
  
  
  METHODS
  Infant birthweight, crown-heel length and head circumference.
  
  
  RESULTS
  After adjustment for gestational age and other potential confounders, the mean birthweight of infants of smokeless tobacco users was reduced by 78 g compared with that of infants of non-users (p=0.18) and by 331 g in infants of smokers (p<0.01). No association was found between maternal smokeless tobacco use and infant length or infant head circumference.
  
  
  CONCLUSIONS
  We found a modest but non-significant reduction in the birthweight of infants of smokeless tobacco users compared with infants of tobacco non-users. Because smokeless tobacco contains many toxic compounds that could affect other pregnancy outcomes, results of this study should not be construed to mean that smokeless tobacco use is safe during pregnancy.
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Lucinda J
authors: LJ
authors: England
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Shin Y
authors: SY
authors: Kim
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Carrie K
authors: CK
authors: Shapiro-Mendoza
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Hoyt G
authors: HG
authors: Wilson
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Juliette S
authors: JS
authors: Kendrick
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Glen A
authors: GA
authors: Satten
authors: Yukon Kuskokwim Health Corporation, Bethel, AK, USA.
authors: Claire A
authors: CA
authors: Lewis
authors: Yukon Kuskokwim Health Corporation, Bethel, AK, USA.
authors: Persenia
authors: P
authors: Whittern
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Myra J
authors: MJ
authors: Tucker
authors: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
authors: William M
authors: WM
authors: Callaghan
mesh_terms: D000328:Adult; D000413:Alaska; D001724:Birth Weight / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects*; D002508:Cephalometry; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007198:Indians, North American; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D014030:Tobacco, Smokeless / Q000009:adverse effects*