An Association between Maternal Smoking and Preeclampsia in Japanese Women

ABSTRACT

In order to determine whether maternal smoking before or during pregnancy, or both, is associated with a reduced risk for preeclampsia in Japanese subjects, we conducted a case-control study that took other risk factors for preeclampsia into consideration. Seventy-one preeclampsia patients were matched with 142 controls for parity and age. Information from a self-administered questionnaire and clinical data such as maternal age, parity, family history of hypertension, prepregnancy body mass index (BMI), and pregnancy outcomes were analyzed. No significant difference was found between the groups in smoking rates before and during pregnancy (38.0 and 18.3% in preeclampsia patients and 38.0 and 16.9% in controls, respectively). However, classification of the subjects according to the presence of "prepregnancy high body mass (BMI ≥ 24)" revealed a significant association between maternal smoking before pregnancy and preeclampsia in women with a prepregnancy high body mass (a smoking rate of 47.6% in patients with preeclampsia and 7.1% in controls, p < 0.05). This result suggests that there is a clear racial difference in the manifestation of preeclampsia with respect to the effect of smoking and that early intervention, particularly before pregnancy, to get obese women to stop smoking may be effective for preventing preeclampsia.

KEYWORD

Preeclampsia - smoking - body mass index - case-control study

REFERENCES

• 1 Conde-Agudelo A, Althabe F, Belizan J M, Kafury-Goeta A C. Cigarette smoking during pregnancy and risk of preeclampsia: a systematic review.  Am J Obstet Gynecol . 1999;  181 1026-1035
• 2 Newman M G, Lindsay M K, Graves W. Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes.  J Matern Fetal Med . 2001;  10 166-170
• 3 Odegard R A, Vatten L J, Nilsen S T, Salvesen K A, Austgulen R. Risk factors and clinical manifestations of pre-eclampsia.  Br J Obstet Gynaecol . 2000;  107 1410-1416
• 4 Martin C L, Hall M H, Campbell D M. The effect of smoking on pre-eclampsia in twin pregnancy.  Br J Obstet Gynaecol . 2000;  107 745-749
• 5 Slome J. Smoking and preeclampsia: is there a relationship?.  J Midwifery Womens Health . 2000;  45 351
• 6 National High Blood Pressure Education Program Working Group. Report on high blood pressure in pregnancy (consensus report).  Am J Obstet Gynecol . 1990;  163 1689-1712
• 7 Journal of Health and Welfare Statistics, Vol 47. Health and Welfare Statistics Association, eds. Tokyo: HWSA; 2000: 90
• 8 Grandone E, Margaglione M, Colaizzo D. Factor V Leiden, C > T MTHFR polymorphism and genetic susceptibility to preeclampsia.  Thromb Haemost . 1997;  77 1052-1054
• 9 Kobashi G, Yamada H, Asano T. The factor V Leiden mutation is not a common cause of pregnancy-induced hypertension in Japan.  Semin Thromb Hemost . 1999;  25 487-489
• 10 Kobashi G, Shido K, Hata A. Multivariate analysis of genetic and acquired factors: T235 variant of angiotensinogen gene as a potent independent risk factor for preeclampsia.  Semin Thromb Hemost . 2001;  27 143-147