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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, Neil
Petrou, Stavros
Boyle, Elaine M.
First Published: 13-May-2015
Publisher: BMJ Publishing Group for Royal College of Paediatrics and Child Health
Citation: Archives of Disease in Childhood : Fetal and Neonatal Edition 2015;100:F486-F491
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 non-smokers (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: 0003-9888
eISSN: 1468-2044
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Appears in Collections:Published Articles, Dept. of Health Sciences

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