title: Maternal Smoking during Pregnancy and Daughters' Preeclampsia Risk.
abstract: BACKGROUND
  An obstetrical paradox is that maternal smoking is protective for the development of preeclampsia. However, there are no prior studies investigating the risk of preeclampsia in women who were exposed to tobacco smoking during their own fetal period. We aimed to study the subsequent risk of preeclampsia in women who were exposed to tobacco smoke in utero, using a national population-based register.
  
  
  METHODS
  Data were obtained from the Medical Birth Register of Sweden for women who were born in 1982 (smoking data first recorded) or after, who had given birth to at least one child; 153 885 pregnancies were included.
  
  
  RESULTS
  The associations between intrauterine smoking exposure (three categories: non-smokers, 1-9 cigarettes/day [moderate exposure], and >9 cigarettes/day [heavy exposure]) and subsequent preeclampsia (n = 5721) were assessed using logistic regressions. In models adjusted for maternal age, parity and own smoking, the odds ratios (OR) for preeclampsia were 1.06 [95% CI: 0.99,1.13 for moderate intrauterine exposure, and 1.18, [95% CI: 1.10,1.27] for heavy exposure. Estimates were slightly strengthened in non-smoking women who experienced heavy intrauterine exposure (adjusted OR 1.24 [95% CI: 1.14,1.34]). Results were no longer statistically significant after adjustment for the woman's own BMI, gestational age and birthweight Z-scores.
  
  
  CONCLUSIONS
  These data revealed some evidence of a possible weak positive association between intrauterine smoking exposure and the risk of subsequent preeclampsia, however, results were not significant over all manifestations of preeclampsia and confounder adjustment. The increased risk might be mediated through exposed women's own BMI or birthweight.
authors.affiliation: Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Mattsson
authors.affiliation: Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Källén
authors.affiliation: Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Rignell-Hydbom
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Stefan R
authors.initials: SR
authors.lastname: Hansson
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: David E
authors.initials: DE
authors.lastname: Cantonwine
authors.affiliation: Division of Occupational and Environmental Medicine, Institute of Laboratory Medicine, Lund University, Lund, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rylander
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D009679:Nuclear Family; D010298:Parity / Q000187:drug effects; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013548:Sweden; D055815:Young Adult