TY - JOUR
T1 - The interrelationship of maternal smoking and increased perinatal mortality with other risk factors. Further analysis of the ontario perinatal mortality study, 1960-1961
AU - Meyer, Mary B.
AU - Tonascia, James A.
AU - Buck, Carol
N1 - Funding Information:
Received for publication May 31, 1974, and in final This study was partially supported by National form July 25, 1974. Institute of Child Health & Human Development 'Department of Epidemiology, Johns Hopkins Contract No. N01-HD-4-2867. University, School of Hygiene and Public Health, 615 The authors thank Miss Margaret Neilson, Medi-North Wolfe Street, Baltimore, Maryland 21205. cal and Nursing Branch, Ontario Ministry of Health, 'Departments of Biostatistics and Epidemiology, for invaluable assistance in the transmission of data, Johns Hopkins University, School of Hygiene and interpretation of codes, and for general liaison as the Public Health. work proceeded. They further thank the Ontario 'Department of Epidemiology and Preventive Ministry of Health for making the study data availa-Medicine, University of Western Ontario, London, ble. Canada.
Funding Information:
The data are from the Ontario Perinatal Mortality Study, which was carried out in 1960-1961 in 10 teaching hospitals in Ontario, and was sponsored and supported by Maternal and Child Health Branch of the Ontario Department of Health. Its purpose was to obtain complete information about the causes of perinatal loss in order to indicate needs for further research, preventive programs, and improved standards of care. Detailed, uniform records were obtained for all single births in these hospitals for the complete years 1960 and 1961, a total of 51,490 births including 701 fetal deaths and 655 early neonatal deaths (under eight days). Data were obtained from interviews with the mothers in the hospital, interviews with anesthetists and attending physicians, and from hospital and autopsy records. The results of the study, published in 1967, show the relationship of perinatal mortality to many
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1974/12
Y1 - 1974/12
N2 - Meyer, M. B., (Johns Hopkins U., School of Hygiene and Public Health. Baltimore, Md. 21205), J. A. Tonascia and C. Buck. The interrelationship of maternal smoking and increased perinatal mortality with other risk factors. Further analysis of the Ontario Perinatal Mortality Study 1960-1961. Am J Epidemiol 100:443-452,1974.-Increased perinatal mortality among smokers babies has been observed in many but not in all studies, with a statistically significant difference in some. This paper explores the hypothesis that maternal smoking may interact with other risk factors, so that a dose-related increase in perinatal mortality may be enhanced or masked depending upon the presence or absence of these factors. Data are from the Ontario Perinatal Mortality Study of all single births in 10 teaching hospitals in Ontario in 1960-1961, a total of 51, 490 births, including 701 fetal deaths and 655 early neonatal deaths. Perinatal mortality increased significantly with smoking, and was also affected by such factors as maternal age, parity, hospital status, previous pregnancy history, hemoglobin level, and others. Smoking frequencies also varied by many of these characteristics. Perinatal mortality was therefore analyzed by the amount smoked during pregnancy within subgroups of these antecedent risk factors. When smoking and other risk factors were cross-tabulated among 52 data subgroups, only the light smokers (<1 pack per day) under age 20 had lower perinatal mortality rates than their nonsmoking counterparts. In almost all subgroups the mortality increase with smoking was dose-related, but not in a simple, linear way. The increased risk of perinatal mortality associated with light smoking among young, low-parity, non-anemic mothers was less than 10%. At the other extreme, mothers of high parity, public hospital status, with previous low birthweight births, or with hemoglobin less than 11 gm had increased perinatal mortality risks of 70-100% when they were heavy smokers. The failure of some studies to find a significant increase in perinatal mortality with maternal smoking may be due to selection of study populations from the end of the spectrum where light smoking is associated with only a slight increase in perinatal risk. Other studies may select higher risk populations, where the influence of smoking on mortality is stronger. Depending on the magnitude of the difference, the amount smoked, and the size of the study, results might or might not be statistically significant.
AB - Meyer, M. B., (Johns Hopkins U., School of Hygiene and Public Health. Baltimore, Md. 21205), J. A. Tonascia and C. Buck. The interrelationship of maternal smoking and increased perinatal mortality with other risk factors. Further analysis of the Ontario Perinatal Mortality Study 1960-1961. Am J Epidemiol 100:443-452,1974.-Increased perinatal mortality among smokers babies has been observed in many but not in all studies, with a statistically significant difference in some. This paper explores the hypothesis that maternal smoking may interact with other risk factors, so that a dose-related increase in perinatal mortality may be enhanced or masked depending upon the presence or absence of these factors. Data are from the Ontario Perinatal Mortality Study of all single births in 10 teaching hospitals in Ontario in 1960-1961, a total of 51, 490 births, including 701 fetal deaths and 655 early neonatal deaths. Perinatal mortality increased significantly with smoking, and was also affected by such factors as maternal age, parity, hospital status, previous pregnancy history, hemoglobin level, and others. Smoking frequencies also varied by many of these characteristics. Perinatal mortality was therefore analyzed by the amount smoked during pregnancy within subgroups of these antecedent risk factors. When smoking and other risk factors were cross-tabulated among 52 data subgroups, only the light smokers (<1 pack per day) under age 20 had lower perinatal mortality rates than their nonsmoking counterparts. In almost all subgroups the mortality increase with smoking was dose-related, but not in a simple, linear way. The increased risk of perinatal mortality associated with light smoking among young, low-parity, non-anemic mothers was less than 10%. At the other extreme, mothers of high parity, public hospital status, with previous low birthweight births, or with hemoglobin less than 11 gm had increased perinatal mortality risks of 70-100% when they were heavy smokers. The failure of some studies to find a significant increase in perinatal mortality with maternal smoking may be due to selection of study populations from the end of the spectrum where light smoking is associated with only a slight increase in perinatal risk. Other studies may select higher risk populations, where the influence of smoking on mortality is stronger. Depending on the magnitude of the difference, the amount smoked, and the size of the study, results might or might not be statistically significant.
KW - Epidemiologic methods
KW - Fetal death
KW - Infant mortality
KW - Maternal age
KW - Parity
KW - Perinatal mortality
KW - Pregnancy
KW - Smoking
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U2 - 10.1093/oxfordjournals.aje.a112056
DO - 10.1093/oxfordjournals.aje.a112056
M3 - Article
C2 - 4447108
AN - SCOPUS:0016353193
SN - 0002-9262
VL - 100
SP - 443
EP - 452
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 6
ER -