J Korean Soc Matern Child Health.  2019 Jul;23(3):155-161. 10.21896/jksmch.2019.23.3.155.

Smoking Exposure and Placental Vascular Compromise: A Nationwide Population-Based Study in South Korea

• Pak H
• Yoon JS
• Baek HW
• Chung JE

• KMID: 2454965
• DOI: http://doi.org/10.21896/jksmch.2019.23.3.155

Abstract

PURPOSE
This study aims to investigate the effects of smoking on the development of placenta-associated syndromes, including preeclampsia, abruptio placentae, and placenta previa, which share the common pathophysiology of vascular compromise of the placenta.
METHODS
A total of 966,629 pregnancies identified from the Korean National Insurance Claims Database and the National Health Information Database were analyzed from 2010 to 2014. The adjusted odds ratio and attributable risk of smoking for the development of placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, were analyzed. Maternal age, alcohol consumption, exercise habit, and economic status were controlled as confounding variables. A binary logistic regression model was used, and simple and multiple logistic regression analyses were performed.
RESULTS
Among 966,629 pregnancies, 11.86% of women were ever smokers. Ever smokers had a higher risk of developing placenta previa (adjusted odds ratio, 1.23; 95% confidence interval [CI], 1.18-1.29; adjusted attributable risk, 18.70%). The adjusted odds ratio of developing placenta-associated syndromes in ever smokers compared to nonsmokers over the age of 35 years with a low economic status was 1.32 (95% CI, 1.18-1.47), with an adjusted attributable risk of 23.95%.
CONCLUSION
The risk of developing placenta-associated syndromes, such as preeclampsia, placenta previa, and abruptio placentae, is high in ever smokers. Pregnant ever smokers who are >35 years and belong to the lower one-third of the economic division require special care to prevent the development of placenta-associated syndromes.

Keyword

Smoking exposure; Placenta-associated syndrome; Placenta vascular compromise

MeSH Terms

Abruptio Placentae
Alcohol Drinking
Confounding Factors (Epidemiology)
Female
Humans
Insurance
Korea*
Logistic Models
Maternal Age
Odds Ratio
Placenta
Placenta Previa
Pre-Eclampsia
Pregnancy
Smoke*
Smoking*
Smoke

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