title: Reassessing the impact of smoking on preeclampsia/eclampsia: are there age and racial differences?
abstract: OBJECTIVE
  To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.
  
  
  METHODS
  This retrospective cohort study was based on the U.S. 2010 natality data. Our study sample included U.S. women who delivered singleton pregnancies between 20 and 44 weeks of gestation without major fetal anomalies in 2010 (n = 3,113,164). Multivariate logistic regression models were fit to estimate crude and adjusted odds ratios and the corresponding 95% confidence intervals.
  
  
  RESULTS
  We observed that the association between maternal smoking and PIH varied by maternal race/ethnicity and age. Compared with non-smokers, reduced odds of PIH among pregnant smokers was only evident for non-Hispanic white and non-Hispanic American Indian women aged less than 35 years. Non-Hispanic Asian/Pacific Islander women who smoked during pregnancy had increased odds of PIH regardless of maternal age. Non-Hispanic white and non-Hispanic black women 35 years or older who smoked during pregnancy also had increased odds of PIH.
  
  
  CONCLUSIONS
  Our study findings suggest important differences by maternal race/ethnicity and age in the association between cigarette use during pregnancy and PIH. More research is needed to establish the biologic and social mechanisms that might explain the variations with maternal age and race/ethnicity that were observed in our study.
authors.affiliation: Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, United States of America.
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: VCU Medical Center, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America.
authors.forename: Jerome F
authors.initials: JF
authors.lastname: Strauss
authors.affiliation: Department of Health Administration, School of Allied Health Professions, Virginia Commonwealth University, Richmond, Virginia, United States of America.
authors.forename: Jon P
authors.initials: JP
authors.lastname: Deshazo
authors.affiliation: Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, United States of America.
authors.forename: Fidelma B
authors.initials: FB
authors.lastname: Rigby
authors.affiliation: Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, United States of America.
authors.forename: David P
authors.initials: DP
authors.lastname: Chelmow
authors.affiliation: Department of Obstetrics and Gynecology, Washington University, St. Louis, Missouri, United States of America.
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004461:Eclampsia / Q000235:genetics*; D005006:Ethnicity; D005260:Female; D056726:Genetic Association Studies; D006801:Humans; D008423:Maternal Age; D011225:Pre-Eclampsia / Q000235:genetics* / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000235:genetics*; D014481:United States; D055815:Young Adult