Lifestyles and pre-eclampsia with special attention to cigarette smoking

J Epidemiol. 2003 Mar;13(2):90-5. doi: 10.2188/jea.13.90.


Cigarette smoking has been reported to protect women against pre-eclampsia. We conducted a cohort study of 493 women whose first antenatal visits were between September 1997 and April 1998 at Osaka Prefectural General Hospital, Japan. A self-administered questionnaire survey for lifestyles was carried out during pregnancy, and pregnancy outcome information was taken from medical record data. Of 493 subjects, 82 cases (16.6%) developed mild pre-eclampsia and 3 cases (0.6%) developed severe one. The prevalence of cigarette smokers decreased from 21.3% to 8.6% during early pregnancy. The incidence rate of pre-eclampsia among smokers was slightly greater than that among non-smokers (19.4% vs 17.1%), the incidence rate among cases exposed from household smoking was greater than that among no exposed cases (19.6% vs 14.3%), and the incidence rate among alcohol-drinkers was greater than that among non-drinkers (21.1% vs 15.1%). However, there were no statistically significant differences. Larger body mass index before pregnancy tended to be associated with the increased incidence rate of pre-eclampsia (p = 0.160). Pregnant women with smoking had a statistically higher frequency of household smoking exposure and having drinking alcohol. Household smoking exposure and drinking alcohol status adjusted hazard rate ratio was 1.1 for smokers (95% confidence interval 0.6-1.7) as compared with that for non-smokers. Our results did not support the proposition that cigarette smoking protected women against pre-eclampsia.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Alcohol Drinking
  • Cohort Studies
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Japan / epidemiology
  • Life Style*
  • Pre-Eclampsia / epidemiology*
  • Pre-Eclampsia / etiology*
  • Pregnancy
  • Pregnancy Outcome
  • Probability
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects*
  • Surveys and Questionnaires