ABSTRACT
We examined the impact of cigarette smoking on fetal growth among twins by analyzing
matched twin live births in the United States from 1995 through 1998. The outcomes
of interest were low and very low birthweight, preterm and very preterm birth, and
small for gestational age. Out of a total of 163,901 mothers, 19,234 reported active
smoking during pregnancy (11.7%). Twins born to smokers weighed an average of 182
g less than their counterparts born to nonsmokers (p < 0.001). The risk for fetal growth inhibition was greater among twins of smokers:
low birthweight (adjusted odds ratio [OR], 1.84; 95% confidence Interval [CI], 1.79
to 1.89), very low birthweight (OR, 1.27; 95% CI, 1.21 to 1.32), preterm (OR, 1.3;
95% CI, 1.09 to 1.16), very preterm (OR, 1.18; 95% CI, 1.13 to 1.23), and small for
gestational age (OR, 1.91; 95% CI, 1.84 to 1.98). In conclusion, prenatal smoking
significantly inhibits fetal growth among twins, and small for gestational age appeared
more affected than shortened gestation.
KEYWORDS
Maternal smoking - fetal growth - twins
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Hamisu SalihuM.D. Ph.D.
Department of Maternal and Child Health, University of Alabama at Birmingham
1665 University Boulevard, Room 320
Birmingham, AL 35294
