Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort
Objective: To compare risk of stillbirth between maternal smokers and those prescribed NRT during pregnancy. Design: Cross-sectional analysis nested in a pregnancy cohort with longitudinal routinely-recorded medical data. Setting: United Kingdom primary care; The Health Improvement Network (TH...
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| Format: | Article |
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Oxford University Press
2018
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| Online Access: | https://eprints.nottingham.ac.uk/49138/ |
| _version_ | 1848797930928996352 |
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| author | Dhalwani, Nafeesa N. Szatkowski, Lisa Coleman, Tim Fiaschi, Linda Tata, Laila J. |
| author_facet | Dhalwani, Nafeesa N. Szatkowski, Lisa Coleman, Tim Fiaschi, Linda Tata, Laila J. |
| author_sort | Dhalwani, Nafeesa N. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objective: To compare risk of stillbirth between maternal smokers and those prescribed NRT during pregnancy.
Design: Cross-sectional analysis nested in a pregnancy cohort with longitudinal routinely-recorded medical data.
Setting: United Kingdom primary care; The Health Improvement Network (THIN) general practice database
Population: 220,630 singleton pregnancies ending in live or stillbirth, 2001-2012
Methods: Women were categorised into three groups: NRT (prescribed during pregnancy or one month before conception); smokers; controls (non-smokers without a pregnancy NRT prescription).
Main Outcome Measure: odds ratios (OR) adjusted to maternal characteristics and 95% confidence intervals (CIs) for stillbirth
Results: A total of 805 pregnancies ended in stillbirth (3.6/1,000 births). Absolute risks of stillbirth in NRT and smoker groups were both 5/1,000 births compared with 3.5/1,000 births in the control group. Compared with the control group, the adjusted odds of stillbirth in the NRT group was not statistically significant (OR=1.35, 95% CI 0.91-2.00), although it was similar in magnitude to that in the smokers group (OR=1.41, 95% CI 1.13-1.77).
Conclusions: We found no evidence of a statistically significant association between being prescribed NRT during pregnancy and odds of stillbirth compared with non-smoking women. Although our study had much larger numbers than any previously, an even larger study with biochemically-validated smoking outcome data and close monitoring of NRT use throughout pregnancy is required to exclude effects on findings of potential exposure misclassification. |
| first_indexed | 2025-11-14T20:11:42Z |
| format | Article |
| id | nottingham-49138 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:11:42Z |
| publishDate | 2018 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-491382020-05-04T19:28:57Z https://eprints.nottingham.ac.uk/49138/ Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort Dhalwani, Nafeesa N. Szatkowski, Lisa Coleman, Tim Fiaschi, Linda Tata, Laila J. Objective: To compare risk of stillbirth between maternal smokers and those prescribed NRT during pregnancy. Design: Cross-sectional analysis nested in a pregnancy cohort with longitudinal routinely-recorded medical data. Setting: United Kingdom primary care; The Health Improvement Network (THIN) general practice database Population: 220,630 singleton pregnancies ending in live or stillbirth, 2001-2012 Methods: Women were categorised into three groups: NRT (prescribed during pregnancy or one month before conception); smokers; controls (non-smokers without a pregnancy NRT prescription). Main Outcome Measure: odds ratios (OR) adjusted to maternal characteristics and 95% confidence intervals (CIs) for stillbirth Results: A total of 805 pregnancies ended in stillbirth (3.6/1,000 births). Absolute risks of stillbirth in NRT and smoker groups were both 5/1,000 births compared with 3.5/1,000 births in the control group. Compared with the control group, the adjusted odds of stillbirth in the NRT group was not statistically significant (OR=1.35, 95% CI 0.91-2.00), although it was similar in magnitude to that in the smokers group (OR=1.41, 95% CI 1.13-1.77). Conclusions: We found no evidence of a statistically significant association between being prescribed NRT during pregnancy and odds of stillbirth compared with non-smoking women. Although our study had much larger numbers than any previously, an even larger study with biochemically-validated smoking outcome data and close monitoring of NRT use throughout pregnancy is required to exclude effects on findings of potential exposure misclassification. Oxford University Press 2018-01-31 Article PeerReviewed Dhalwani, Nafeesa N., Szatkowski, Lisa, Coleman, Tim, Fiaschi, Linda and Tata, Laila J. (2018) Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort. Nicotine and Tobacco Research, 21 (4). pp. 409-415. ISSN 1469-994X Stillbirth; Nicotine replacement therapy; Smoking; Pregnancy; Maternal smoking https://academic.oup.com/ntr/article/21/4/409/4831224 doi:10.1093/ntr/nty019 doi:10.1093/ntr/nty019 |
| spellingShingle | Stillbirth; Nicotine replacement therapy; Smoking; Pregnancy; Maternal smoking Dhalwani, Nafeesa N. Szatkowski, Lisa Coleman, Tim Fiaschi, Linda Tata, Laila J. Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title | Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title_full | Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title_fullStr | Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title_full_unstemmed | Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title_short | Stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large UK pregnancy cohort |
| title_sort | stillbirth among women prescribed nicotine replacement therapy in pregnancy: analysis of a large uk pregnancy cohort |
| topic | Stillbirth; Nicotine replacement therapy; Smoking; Pregnancy; Maternal smoking |
| url | https://eprints.nottingham.ac.uk/49138/ https://eprints.nottingham.ac.uk/49138/ https://eprints.nottingham.ac.uk/49138/ |