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Title: Associations between late and moderately preterm birth and smoking, alcohol, drug-use and diet: A population based case-cohort study
Authors: Smith, Lucy K.
Draper, Elizabeth S.
Evans, T. Alun
Field, David J.
Johnson, Samantha J.
Manktelow, Bradley N.
Seaton, Sarah E.
Marlow, N.
Petrou, S.
Boyle, Elaine M.
First Published: 13-May-2015
Publisher: BMJ Publishing Group
Citation: Archives of Disease in Childhood Fetal and Neonatal Edition 2015
Abstract: Objective: This study explores the associations between lifestyle factors and late and moderate preterm birth (LMPT: 32+0-36+6 weeks gestation), a relatively under-researched group. Study design: A population based case-cohort study was undertaken involving 922 LMPT and 965 term (37+ weeks gestation) singleton live and stillbirths born between 01/09/2009-31/12/2010 to women residing in Leicestershire and Nottinghamshire, UK. Poisson multivariable regression models were fitted to estimate relative risks (RR) of LMPT birth associated with maternal smoking, alcohol and recreational drug use, and diet. Results: Women who smoked during pregnancy were at 38% increased risk of LMPT birth compared to nonsmokers (RR 1.38 95% CI (1.04 to 1.84)). Low consumption of fruit and vegetables was associated with a 31% increased risk compared to those who reported eating higher consumption levels (RR 1.31 (1.03 to 1.66)). Women who did not have any aspects of a Mediterranean diet were nearly twice as likely to deliver LMPT compared to those whose diet included more Mediterranean characteristics (RR 1.81 (1.04 to 3.14)). Women who smoked and consumed low levels of fruit and vegetables (5%) were at particularly high risk (RR=1.81 (1.29 to 2.55)). There was no significant effect of alcohol or recreational drug use on LMPT birth. Conclusions: Smoking and poor diet during pregnancy, factors that strongly impact on very preterm birth, are also important at later gestations and experienced together are associated with an elevated rate of risk. Our findings suggest early cessation of smoking during pregnancy may be an effective strategy to reduce LMPT births.
DOI Link: 10.1136/archdischild-2014-307265
ISSN: 1359-2998
eISSN: 1468-2052
Version: Published
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © the authors, 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (, which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.
Appears in Collections:Published Articles, Dept. of Health Sciences

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