Adverse pregnancy outcomes in snuff users

Am J Obstet Gynecol. 2003 Oct;189(4):939-43. doi: 10.1067/s0002-9378(03)00661-6.


Objective: The purpose of the study was to evaluate the effects of smokeless tobacco use during pregnancy.

Study design: We examined birth weight, preterm delivery, and preeclampsia in women who were delivered of singleton, live-born infants in Sweden from 1999 through 2000. For each snuff user, 10 cigarette smokers and 10 tobacco nonusers were selected randomly.

Results: After exclusions, 789 snuff users, 11,240 smokers, and 11,495 nonusers remained. Compared with nonusers, adjusted mean birth weight was reduced in snuff users by 39 g (95% CI, 6-72 g) and in smokers by 190 g (95% CI, 178-202 g). Preterm delivery was increased in snuff users and smokers (adjusted odds ratios, 1.98 [95% CI, 1.46-2.68] and 1.57 [95% CI, 1.38-1.80], respectively). Preeclampsia was reduced in smokers (adjusted odds ratio, 0.63; 95% CI, 0.53-0.75) but increased in snuff users (adjusted odds ratio, 1.58; 95% CI, 1.09-2.27).

Conclusion: Snuff use was associated with increased risk of preterm delivery and preeclampsia. Snuff does not appear to be a safe alternative to cigarettes during pregnancy.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Birth Weight
  • Female
  • Humans
  • Obstetric Labor, Premature / epidemiology
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Pregnancy Outcome*
  • Risk Factors
  • Smoking / adverse effects
  • Tobacco, Smokeless / adverse effects*