Hyperglycaemia in Pregnancy Is Less Frequent in Smokers: A French Observational Study of 15,801 Women

Author:

Cosson Emmanuel12ORCID,Tatulashvili Sopio12,Vicaut Eric3ORCID,Carbillon Lionel4,Bihan Hélène1ORCID,Rezgani Imen1,Pinto Sara1ORCID,Sal Meriem1,Zerguine Mohamed1,Fermaut Marion4,Portal Jean-Jacques3ORCID,Puder Jardena J.5ORCID,Benbara Amélie4

Affiliation:

1. AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France

2. INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, 93017 Bobigny, France

3. AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France

4. AP-HP, Jean Verdier Hospital, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Paris 13 University, 93140 Bondy, France

5. Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, 1000 Lausanne, Switzerland

Abstract

Background: We aimed to explore the still-debated association between smoking and hyperglycaemia in pregnancy (HIP). Methods: A multiethnic prospective study of 15,801 women who delivered at Jean Verdier University Hospital between 2012 and 2018. Of these, 13,943 (88.2%) were non-smokers, 624 (4.5%) former smokers, and 1234 (7.8%) current smokers. Universal HIP screening was proposed to the entire sample (IADPSG/WHO criteria). Results: A total of 13,958 women were screened for HIP. Uptake differed between non-smokers, former smokers, and current smokers (89.5%, 88.3%, and 75.7%, respectively, p < 0.0001). HIP prevalence in these groups was 19.9%, 15.4%, and 12.3%, respectively (p < 0.0001). After adjusting for age, body mass index, family history of diabetes, history of HIP, history of macrosomic baby, and ethnicity, current (odds ratio 0.790 [95% confidence interval 0.636–0.981], p < 0.05) but not former (1.017 [0.792–1.306]) smokers were less likely to have HIP than non-smokers. Furthermore, 1 h and 2 h oral plasma glucose test values were lower in current smokers than in non-smokers (p < 0.01). To exclude potential selection bias, we compared risk factors for HIP and HIP-related adverse pregnancy outcomes in current smokers according to HIP screening status. Compared with screened current smokers (n = 934), their unscreened counterparts (n = 300) were younger, less frequently employed, and more likely to be of non-European origin. Moreover, infant birthweight was lower in this group, and preterm deliveries and perinatal deaths were more likely (all p < 0.01). Conclusions: Smoking during pregnancy was independently associated with lower HIP prevalence. The low HIP screening rate in current smokers did not explain this finding.

Publisher

MDPI AG

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