American Journal of Epidemiology Vol. 148, No. 2: 215-221
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Maternal Cigarette Smoking, Regular Use of Multivitamin/Mineral Supplements, and Risk of Fetal Death
The 1988 National Maternal and Infant Health Survey
From the Department of Social and Preventive Medicine, School of Medicine and Biomedical Science, State University of New York at Buffalo Buffalo, NY
Reprint requests to Dr. Tiejian Wu, Department of Social and Preventive Medicine, School of Medicine and Biomedical Science, State University of New York at Buffalo, 270 Farber Hall, Buffalo, NY 14214
Data from the 1988 National Maternal and Infant Health Survey were used to examine whether regular use of multivitamin/mineral supplements could modify the relation between maternal smoking and fetal death. Maternal smoking was defined as the self-reported average number of cigarettes smoked after recognition of pregnancy. Regular supplement use was defined as use of multivitamin/mineral supplements for at least 3 days per week during the 3 months before and/or after recognition of pregnancy. The sample comprises 12,465 singleton pregnancies, including 9,402 livebirths and 3,063 fetal deaths. Odds ratios were derived from logistic regression analyses after adjustment for a number of demographic and reproductive variables. Major findings are that 1) smoking increased the risk of fetal death; 2) regular supplement use either before or after recognition of pregnancy did not affect the risk of fetal death in the absence of maternal smoking; 3) odds ratios for fetal death among smoking women who regularly used supplements were generally smaller than those for women who did not regularly use supplements but who smoked a comparable number of cigarettes; and 4) a significant negative excess risk due to interaction was observed among women who regularly used supplements before recognition of pregnancy and smoked 20 or more cigarettes a day. These findings suggested that regular multivitamin/mineral supplement use might reduce the risk of fetal death associated with maternal smoking. Am J Epidemiol 1998;148:215–21.
effect modifiers (epidemiology); fetal death; minerals; smoking; vitamins
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