Association of reported trimester-specific smoking cessation with fetal growth restriction

Kaitlin Blatt, Elizabeth Moore, Aimin Chen, James Van Hook, Emily A. Defranco

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Objective: To assess the association of reported smoking cessation at various time points during pregnancy with fetal growth restriction. Methods: This was a population-based retrospective cohort study of singleton nonanomalous live births using Ohio birth certificates, 2006-2012. Outcomes of women who reported smoking only in the 3 months before conception and women who reported smoking through the first, second, or third trimester were compared with a referent group of nonsmokers. Multivariate logistic regression assessed the association between smoking cessation at various times in pregnancy and fetal growth restriction less than the 10th and 5th percentiles. Results: Of 927,424 births analyzed, 75% of mothers did not smoke. Of smokers, 24% smoked preconception only, 10% quit after the first trimester, 4% quit after the second trimester, and 59% smoked throughout pregnancy. The rate of fetal growth restriction less than the 10th and 5th percentiles among nonsmokers was 8.1% and 3.6%, respectively. Although smoking only in the preconception period did not significantly increase fetal growth restriction risk, smoking in any trimester did. The adjusted odds ratio (95% confidence interval) for fetal growth restriction less than the 10th and 5th percentiles, respectively, of cessation after the first trimester was 1.19 (1.13-1.24) and 1.25 (1.17-1.33) and 1.67 (1.57-1.78) and 1.83 (1.68, 1.99) for cessation after the second trimester. Women who reported smoking throughout pregnancy had the highest risks of fetal growth restriction, 2.26 (2.22-2.31) and 2.44 (2.37-2.51), after accounting for the influence of race, low socioeconomic status, and medical comorbidities. Conclusion: Smoking of any duration during pregnancy is associated with an increased risk of fetal growth restriction with decreasing risk the earlier that cessation occurs. Smoking cessation programs should focus on the benefit of quitting as early in pregnancy as possible.

Original languageEnglish
Pages (from-to)1452-1459
Number of pages8
JournalObstetrics and Gynecology
Issue number6
StatePublished - Jun 28 2015

Bibliographical note

Publisher Copyright:
© © 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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