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Cited by 123Smoking Behavior and CessationPrenatal Substance Exposure EffectsGlobal Maternal and Child Health

The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.

Smokeless Tobacco Use and Risk of Stillbirth: A Cohort Study in Mumbai, India

Gupta, Prakash Chandra, Subramoney, Sreevidya·2006·Epidemiology
DOI 10.1097/01.ede.0000190545.19168.c4
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Abstract

BACKGROUND: Maternal cigarette smoking has been causally associated with an increased risk for stillbirth. Preliminary reports suggest an increased risk for stillbirth with smokeless tobacco use during pregnancy. METHODS: We conducted a population-based prospective cohort study to investigate this association by using a house-to-house approach to recruit 1,217 women who were between 3 and 7 months' gestation. Of these, 96% were contacted after delivery to determine the pregnancy outcome. Demographic and maternal variables which were apparently associated either with stillbirth or with smokeless tobacco use (OR >or= 1.5) were included as potential confounders. Stillbirth was defined as any delivery of a dead fetus after 20 completed weeks of gestation. We used time-to-event methods to analyze the risk of stillbirth. RESULTS: Overall occurrence of stillbirth among singleton deliveries in this population was 4.1%. Smokeless tobacco use was reported by 17% of women; 8.9% of smokeless tobacco users had a stillbirth compared with 3.1% among nonusers (life-table adjusted hazard ratio = 3.1; 95% confidence interval = 1.7-5.6). After adjustment by the Cox proportional hazards procedure for age, educational and socioeconomic background, working status of mother, parity, prenatal care variables, and place of delivery, the risk for stillbirth in users was 2.6 (95% confidence interval-1.4-4.8). Most women used mishri (a pyrolyzed tobacco product often used as dentifrice), and there was a dose-response relationship between the daily frequency of use and stillbirth risk. The risk of stillbirth associated with smokeless tobacco use was greater in earlier gestational periods. CONCLUSIONS: Smokeless tobacco use during pregnancy increases stillbirth risk, with a risk at least as great as that associated with maternal cigarette smoking.

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Research works printed but not linked: 3

  1. Shah, 2000, Prenat Neonat Med, 5, 288
  2. Agrawal, 1983, Indian Pediatr, 20, 561
  3. Yang, 1999, Public Health, 113, 189, 10.1016/S0033-3506(99)00152-3 · DOI

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Metadata

Authors
Gupta, P. C., & Subramoney, S.
Affiliations
Tata Institute of Fundamental Research (IN)
Corresponding author
Subramoney, Sreevidya
ORCID
Venue
Epidemiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-01
Volume
17
Issue
1
Pages
47-51
ISSN
1044-3983 (ISSN-L)
DOI
10.1097/01.ede.0000190545.19168.c4
OpenAlex
W1975378478
Cited by
123
References
13
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 5 · 2020: 7 · 2019: 3 · 2018: 9 · 2017: 6 · 2016: 9 · 2015: 9 · 2014: 7 · 2013: 5 · 2012: 12
FWCI
2.38
Type
journal article
Language
en
Open access
closed
Locations
  • Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
smokeless tobacco, stillbirth, pregnancy, maternal smoking, prenatal exposure, dose-response relationship, gestational age, pregnancy outcomes
MeSH terms
Adult, Female, Humans, India, Pregnancy, Socioeconomic Factors, Tobacco, Smokeless, Cohort Studies, Stillbirth

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