Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy
Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007–2010 matched...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2018/2782741 |
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| author | Lucia Borsari Carlotta Malagoli Martha M. Werler Kenneth J. Rothman Marcella Malavolti Rossella Rodolfi Gianfranco De Girolamo Fausto Nicolini Marco Vinceti |
| author_facet | Lucia Borsari Carlotta Malagoli Martha M. Werler Kenneth J. Rothman Marcella Malavolti Rossella Rodolfi Gianfranco De Girolamo Fausto Nicolini Marco Vinceti |
| author_sort | Lucia Borsari |
| collection | DOAJ |
| description | Smoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007–2010 matched 1 : 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other’s effect on preterm birth and congenital anomalies. |
| format | Article |
| id | doaj-art-d61e25807bb9412aac78ea263a29b232 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-d61e25807bb9412aac78ea263a29b2322025-02-03T01:11:28ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/27827412782741Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern ItalyLucia Borsari0Carlotta Malagoli1Martha M. Werler2Kenneth J. Rothman3Marcella Malavolti4Rossella Rodolfi5Gianfranco De Girolamo6Fausto Nicolini7Marco Vinceti8Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, ItalyClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, ItalyLocal Health Authority of Reggio Emilia, Reggio Emilia 42122, ItalyDepartment of Public Health, Unit of Epidemiology and Risk Communication, Local Health Authority of Modena, Modena 41126, ItalyLocal Health Authority of Reggio Emilia, Reggio Emilia 42122, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena 41125, ItalySmoking and pregestational diabetes (PGD) are recognized risk factors for adverse pregnancy outcomes, but to date, no population-based study has investigated their joint effects. Using hospital discharges, we identified all women with PGD delivering in Emilia-Romagna region during 2007–2010 matched 1 : 5 with parturients without diabetes. Our study endpoints were preterm births and congenital anomalies. We measured interaction between PGD and maternal smoking, by calculating excess prevalence and prevalence ratio due to interaction, relative excess risk due to interaction (RERI), attributable proportion (AP), and the synergy index (S). Analyses were performed in the overall study population and in the subgroup whose PGD was validated through diabetes registers. The study included 992 women with PGD (10.5% smokers) and 4788 comparison women (11.9% smokers). The effects of PGD and maternal tobacco smoking were greater than additive for both preterm birth (excess prevalence due to interaction = 11.7%, excess ratio due to interaction = 1.5, RERI = 2.39, AP = 0.51, S = 2.82) and congenital anomalies (excess prevalence due to interaction = 2.2%, excess ratio due to interaction = 1.3, RERI = 1.33, AP = 0.49, S = 5.03). Joint effect on both endpoints was confirmed in the subgroup whose PGD status was validated. In conclusion, we found that maternal tobacco smoking and PGD intensify each other’s effect on preterm birth and congenital anomalies.http://dx.doi.org/10.1155/2018/2782741 |
| spellingShingle | Lucia Borsari Carlotta Malagoli Martha M. Werler Kenneth J. Rothman Marcella Malavolti Rossella Rodolfi Gianfranco De Girolamo Fausto Nicolini Marco Vinceti Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy Journal of Diabetes Research |
| title | Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy |
| title_full | Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy |
| title_fullStr | Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy |
| title_full_unstemmed | Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy |
| title_short | Joint Effect of Maternal Tobacco Smoking and Pregestational Diabetes on Preterm Births and Congenital Anomalies: A Population-Based Study in Northern Italy |
| title_sort | joint effect of maternal tobacco smoking and pregestational diabetes on preterm births and congenital anomalies a population based study in northern italy |
| url | http://dx.doi.org/10.1155/2018/2782741 |
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