Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire

Abstract Background Placental abruption (PA) is a critical obstetric complication, with maternal smoking recognized as a key risk factor. Despite the increased use of heated tobacco products (HTPs), the impact of HTPs remains unclear. This study investigated whether pregnant women using HTPs are at...

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Main Authors: Hikaru Ooba, Jota Maki, Takahiro Tabuchi, Hisashi Masuyama
Format: Article
Language:English
Published: Springer 2025-02-01
Series:Journal of Epidemiology and Global Health
Subjects:
Online Access:https://doi.org/10.1007/s44197-025-00373-2
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author Hikaru Ooba
Jota Maki
Takahiro Tabuchi
Hisashi Masuyama
author_facet Hikaru Ooba
Jota Maki
Takahiro Tabuchi
Hisashi Masuyama
author_sort Hikaru Ooba
collection DOAJ
description Abstract Background Placental abruption (PA) is a critical obstetric complication, with maternal smoking recognized as a key risk factor. Despite the increased use of heated tobacco products (HTPs), the impact of HTPs remains unclear. This study investigated whether pregnant women using HTPs are at a higher risk of PA than non-users. Methods We analyzed data from “the Japan COVID-19 and Society Internet Survey,” a prospective, self-reported online survey cohort. Questionnaires were randomly distributed between July 28, 2021, and August 30, 2021. Pregnant respondents in 2021 were invited to complete an additional survey from February 14, 2022, to February 28, 2022. We set the outcome as the absolute risk difference (aRD) and relative risk ratio (rRR) of PA incidence due to smoking HTPs in the first trimester of pregnancy. The sample size included 12 836 participants. We calculated outcomes using a generalized linear model (GLM) and inverse probability of treatment weighting (IPTW). We also performed a Bayesian approach and multiple-bias analysis for sensitivity analysis. Results We found the robust aRD of 0.07 (95% confidence interval (CI): 0.06, 0.09) and the rRR of 11.3 (95% CI: 7.5, 17.0). Multiple bias analyses showed that unmeasurable confounders would need to have at least an rRR = 14 relationship with both exposure and outcome to disprove the observed association. There has not been post hoc analysis or secondary use of data. Conclusion Early pregnancy use of HTPs is associated with an increased risk of PA.
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spelling doaj-art-23a61bda1638435bb0e5dfbd546dc0d82025-08-20T03:11:07ZengSpringerJournal of Epidemiology and Global Health2210-60142025-02-011511810.1007/s44197-025-00373-2Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online QuestionnaireHikaru Ooba0Jota Maki1Takahiro Tabuchi2Hisashi Masuyama3Center for Innovative Clinical Medicine, Okayama University HospitalDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of MedicineDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAbstract Background Placental abruption (PA) is a critical obstetric complication, with maternal smoking recognized as a key risk factor. Despite the increased use of heated tobacco products (HTPs), the impact of HTPs remains unclear. This study investigated whether pregnant women using HTPs are at a higher risk of PA than non-users. Methods We analyzed data from “the Japan COVID-19 and Society Internet Survey,” a prospective, self-reported online survey cohort. Questionnaires were randomly distributed between July 28, 2021, and August 30, 2021. Pregnant respondents in 2021 were invited to complete an additional survey from February 14, 2022, to February 28, 2022. We set the outcome as the absolute risk difference (aRD) and relative risk ratio (rRR) of PA incidence due to smoking HTPs in the first trimester of pregnancy. The sample size included 12 836 participants. We calculated outcomes using a generalized linear model (GLM) and inverse probability of treatment weighting (IPTW). We also performed a Bayesian approach and multiple-bias analysis for sensitivity analysis. Results We found the robust aRD of 0.07 (95% confidence interval (CI): 0.06, 0.09) and the rRR of 11.3 (95% CI: 7.5, 17.0). Multiple bias analyses showed that unmeasurable confounders would need to have at least an rRR = 14 relationship with both exposure and outcome to disprove the observed association. There has not been post hoc analysis or secondary use of data. Conclusion Early pregnancy use of HTPs is associated with an increased risk of PA.https://doi.org/10.1007/s44197-025-00373-2Placental abruptionHeated tobacco productsPregnancyTobacco use
spellingShingle Hikaru Ooba
Jota Maki
Takahiro Tabuchi
Hisashi Masuyama
Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
Journal of Epidemiology and Global Health
Placental abruption
Heated tobacco products
Pregnancy
Tobacco use
title Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
title_full Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
title_fullStr Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
title_full_unstemmed Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
title_short Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire
title_sort relationship between heated tobacco products and placental abruption a prospective cohort study using online questionnaire
topic Placental abruption
Heated tobacco products
Pregnancy
Tobacco use
url https://doi.org/10.1007/s44197-025-00373-2
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AT jotamaki relationshipbetweenheatedtobaccoproductsandplacentalabruptionaprospectivecohortstudyusingonlinequestionnaire
AT takahirotabuchi relationshipbetweenheatedtobaccoproductsandplacentalabruptionaprospectivecohortstudyusingonlinequestionnaire
AT hisashimasuyama relationshipbetweenheatedtobaccoproductsandplacentalabruptionaprospectivecohortstudyusingonlinequestionnaire