Author(s): Wikstrm AK, Cnattingius S, Galanti MR, Kieler H, Stephansson O
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Abstract OBJECTIVE: To compare the effects of Swedish snuff and cigarette smoking on risks of preterm birth. DESIGN: Population-based cohort study. SETTING: Sweden. POPULATION: All live, singleton births in Sweden 1999-2006. METHODS: Odds ratios (OR) with 95\% confidence intervals (CI) were used to estimate relative risks for preterm birth in snuff users (n = 7607), light smokers (1-9 cigarettes/day; n = 41 436) and heavy smokers (ten or more cigarettes/day; n = 16 951) using non-tobacco users (n = 503 957) as reference. MAIN OUTCOME MEASURES: Very (<32 weeks) and moderately (32-36 weeks) preterm birth. RESULTS: Compared with non-tobacco users, snuff users had increased risks of both very (adjusted OR 1.38; 95\% CI 1.04-1.83) and moderately (adjusted OR 1.25; 95\% CI 1.12-1.40) preterm birth. Compared with non-tobacco users, light smokers had increased risks of both very (adjusted OR 1.60; 95\% CI 1.42-1.81) and moderately (adjusted OR: 1.18; 95\% CI: 1.12-1.24) preterm birth, and heavy smokers had even higher risks. Among smokers, but not among snuff users, the risk was more pronounced for spontaneous than induced preterm birth. CONCLUSIONS: The use of Swedish snuff was associated with increased risks of very and moderately preterm birth with both spontaneous and induced onsets. Swedish snuff is not a safe alternative to cigarette smoking during pregnancy.
This article was published in BJOG
and referenced in Journal of Antivirals & Antiretrovirals