Effects of smoking and preeclampsia on birth weight for gestational age

J Matern Fetal Neonatal Med. 2015 Apr;28(6):679-84. doi: 10.3109/14767058.2014.928853. Epub 2014 Jun 26.


Objective: A counterintuitive interaction between smoking during pregnancy and preeclampsia on birth weight for gestational age (BWGA) outcomes was recently reported. In this report, we examine the relationship between these factors in a well-documented study population with exposure data on trimester of maternal smoking.

Methods: Preeclamptic (n = 238), gestational hypertensive (n = 219), and normotensive women (n = 342) were selected from live-births to nulliparous Iowa women. Disease status was verified by medical chart review, and smoking exposure was assessed by self-report. Fetal growth was assessed as z-score of BWGA. Multiple linear regression was used to test for the association of maternal smoking and preeclampsia with BWGA z-score.

Results: There was no interaction between smoking with preeclampsia or gestational hypertension on fetal growth. BWGA z-scores were significantly lower among women with preeclampsia and those who smoked any time during pregnancy (β = -0.33, p = <0.0001 and β = -0.25, p = 0.05) compared to normotensive and non-smoking women, respectively. Infants of women with gestational hypertension were comparable in size to infants born to normotensive women.

Conclusions: Women who developed preeclampsia and those who smoked during pregnancy delivered infants that were significantly smaller than infants of women who did not develop preeclampsia and non-smoking women, respectively.

Keywords: Epidemiology; fetal growth; low birth weight; pregnancy; z-score.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight*
  • Case-Control Studies
  • Female
  • Fetal Development / physiology*
  • Fetal Growth Retardation / epidemiology
  • Gestational Age*
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology
  • Infant, Newborn
  • Iowa / epidemiology
  • Pre-Eclampsia / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Smoking / adverse effects
  • Smoking / epidemiology*
  • Young Adult