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Am J Perinatol 2013; 30(10): 821-826
DOI: 10.1055/s-0032-1333408
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Increased Risk of Preterm Premature Rupture of Membranes at Early Gestational Ages among Maternal Cigarette Smokers

Mary C. England
1   Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
,
Alice Benjamin
3   Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
,
Haim A. Abenhaim
2   Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
› Author Affiliations
Further Information

Publication History

28 August 2012

10 November 2012

Publication Date:
17 January 2013 (online)

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Abstract

Objective To examine the effect of cigarette smoking during pregnancy on the development of preterm premature rupture of membranes (PPROM) categorized by gestational age.

Methods We conducted a retrospective cohort study of 17,961 births using data from the McGill Obstetric and Neonatal Database between years 2001 and 2006. Our exposure was defined according to self-reported maternal cigarette smoking status categorized as nonsmoker, smoker of 1 to 10 cigarettes per day, and smoker of > 10 cigarettes per day. The outcome was measured as incidence of premature rupture of membranes (PROM) among gestational age categories of < 28, < 32, < 37, and > 37 weeks. Unconditional logistic regression analysis and Wald test for trend were used to estimate the adjusted risk of PPROM according to smoking status.

Results Among the study population, 640 cases of PPROM (<37 weeks) and 40 cases of PROM (>37 weeks). After adjusting for confounding variables, smoking > 10 cigarettes per day was associated with an increased risk of PPROM at < 28 weeks (odds ratio [OR] 5.28; 95% confidence interval [CI] 2.20 to 12.7); < 32 weeks (OR 2.36; 95% CI 1.09 to 5.11; < 37 weeks (OR 1.97; 95% CI 1.32 to 2.94); and > 37 weeks (OR 3.19; 95% CI 0.92 to 11.0). Smoking 1 to 10 cigarettes per day was not associated with a significant risk of PPROM at any gestational age.

Conclusion Heavy cigarette smoking increases the risk of PPROM more so at early gestational age than at term.

Keywords

cigarette smoking - premature rupture of membranes - gestational age

Note

This study was financed within the department.


 

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