Angela Ratsch1, Fiona Bogossian. 1. Queensland Health and School of Nursing and Midwifery, The University of Queensland, Brisbane, Australia, angela.ratsch@health.qld.gov.au.
Abstract
OBJECTIVES: To systematically critique and summarise the available evidence on the outcomes of smokeless tobacco use in pregnancy to inform the public health response. METHODS: In March 2013, a search was conducted of observational studies where the exposure to smokeless tobacco during pregnancy and maternal, placental and/or neonatal outcomes was assessed. Two reviewers extracted data and completed quality assessment of the literature utilizing the Agency for Healthcare Research and Quality criteria (West et al. 2002). RESULTS: The search resulted in 211 articles, 21 (10%) of which met the final criteria for integrative review. Ten (10) of the studies are from India, seven (7) from Sweden, two (2) from Alaska and one (1) each from South Africa and Pakistan. CONCLUSIONS: Many studies lacked sufficient power to estimate precise risks. Most reports were hindered by imprecise measures of exposure and lack of confounding variable control. However, there were indications that maternal smokeless tobacco use increases rates of stillbirth, low birth weight and alters the male:female live birth ratio. Maternal smokeless tobacco use may not be safe for mother or foetus.
OBJECTIVES: To systematically critique and summarise the available evidence on the outcomes of smokeless tobacco use in pregnancy to inform the public health response. METHODS: In March 2013, a search was conducted of observational studies where the exposure to smokeless tobacco during pregnancy and maternal, placental and/or neonatal outcomes was assessed. Two reviewers extracted data and completed quality assessment of the literature utilizing the Agency for Healthcare Research and Quality criteria (West et al. 2002). RESULTS: The search resulted in 211 articles, 21 (10%) of which met the final criteria for integrative review. Ten (10) of the studies are from India, seven (7) from Sweden, two (2) from Alaska and one (1) each from South Africa and Pakistan. CONCLUSIONS: Many studies lacked sufficient power to estimate precise risks. Most reports were hindered by imprecise measures of exposure and lack of confounding variable control. However, there were indications that maternal smokeless tobacco use increases rates of stillbirth, low birth weight and alters the male:female live birth ratio. Maternal smokeless tobacco use may not be safe for mother or foetus.
Authors: Lucinda J England; Richard J Levine; James L Mills; Mark A Klebanoff; Kai F Yu; Sven Cnattingius Journal: Am J Obstet Gynecol Date: 2003-10 Impact factor: 8.661
Authors: Gary A Giovino; Sara A Mirza; Jonathan M Samet; Prakash C Gupta; Martin J Jarvis; Neeraj Bhala; Richard Peto; Witold Zatonski; Jason Hsia; Jeremy Morton; Krishna M Palipudi; Samira Asma Journal: Lancet Date: 2012-08-18 Impact factor: 79.321
Authors: Anna V Wilkinson; Laura M Koehly; Elizabeth A Vandewater; Robert K Yu; Susan P Fisher-Hoch; Alexander V Prokhorov; Harold W Kohl; Margaret R Spitz; Sanjay Shete Journal: BMC Med Genet Date: 2015-06-26 Impact factor: 2.103