New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study
Abstract Introduction Pregnancy itself predisposes to urinary tract infections (UTI). There appears to be a higher prevalence of infections and genitourinary diseases among pregnant smokers than among non‐smokers. The present study is a retrospective observational register study aiming to investigat...
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Wiley
2023-01-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14473 |
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| author | Hanna P. Wallin Mika Gissler Päivi E. Korhonen Mikael O. Ekblad |
| author_facet | Hanna P. Wallin Mika Gissler Päivi E. Korhonen Mikael O. Ekblad |
| author_sort | Hanna P. Wallin |
| collection | DOAJ |
| description | Abstract Introduction Pregnancy itself predisposes to urinary tract infections (UTI). There appears to be a higher prevalence of infections and genitourinary diseases among pregnant smokers than among non‐smokers. The present study is a retrospective observational register study aiming to investigate whether maternal smoking is associated with the prevalence of UTIs during pregnancy by utilizing a pregnancy‐pair analysis. Material and Methods Information about pregnancies and maternal smoking was obtained from the Finnish Medical Birth Register. The study sample consisted of all singleton pregnancies (n = 723 433) of women giving birth between January 2006 and December 2018 in Finland. Information on maternal smoking was collected in three categories: (1) non‐smoking; (2) quit smoking during the first trimester; and (3) continued smoking throughout the pregnancy. Information about maternal UTI diagnoses during pregnancy was received from the Hospital Discharge Register and the Medical Birth Register. UTIs were categorized as lower and upper UTIs according to the International Statistical Classification of Diseases and Related Health Problems (ICD)–10 diagnosis codes. Risks were calculated as odds ratios (OR) by logistic regression with 95% confidence intervals (CI) further adjusted for maternal characteristics (aOR). Finally, pregnancy‐pair analyses were performed: mothers who had changed smoking status (no smoking/any smoking) between consecutive pregnancies (n = 27 246 pregnancy‐pairs) were analyzed as one cluster and compared with non‐smokers. Results Smokers had UTIs more often compared with the non‐smokers. The association was even stronger among those who continued to smoke (aOR 1.60, 95% CI 1.51–1.70) than among those who smoked only during the first trimester (aOR 1.27, 95% CI 1.18–1.37) compared with non‐smokers. In pregnancy‐pair analysis, smoking was associated with upper UTIs during pregnancy (OR 1.49, 95% CI 1.05–2.12) compared with non‐smokers, but after the adjustments this association was attenuated (aOR 1.27, 95% CI 0.88–1.82). No association in lower UTIs was observed in the pregnancy‐pair design. Conclusions Maternal smoking was associated with a higher prevalence of UTIs during pregnancy in the standard comparison. The observed association was fully attenuated in the pregnancy‐pair analysis, in which smoking was dichotomized. This study suggests that the association between maternal smoking during pregnancy and adverse maternal health effects might be more complex than previously thought. |
| format | Article |
| id | doaj-art-2e337f6537e24dcda88bce461db2bf3c |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-2e337f6537e24dcda88bce461db2bf3c2025-08-20T02:09:35ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-01-011021253210.1111/aogs.14473New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register studyHanna P. Wallin0Mika Gissler1Päivi E. Korhonen2Mikael O. Ekblad3Department of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital Turku FinlandTHL Finnish Institute for Health and Welfare Helsinki FinlandDepartment of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital Turku FinlandDepartment of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital Turku FinlandAbstract Introduction Pregnancy itself predisposes to urinary tract infections (UTI). There appears to be a higher prevalence of infections and genitourinary diseases among pregnant smokers than among non‐smokers. The present study is a retrospective observational register study aiming to investigate whether maternal smoking is associated with the prevalence of UTIs during pregnancy by utilizing a pregnancy‐pair analysis. Material and Methods Information about pregnancies and maternal smoking was obtained from the Finnish Medical Birth Register. The study sample consisted of all singleton pregnancies (n = 723 433) of women giving birth between January 2006 and December 2018 in Finland. Information on maternal smoking was collected in three categories: (1) non‐smoking; (2) quit smoking during the first trimester; and (3) continued smoking throughout the pregnancy. Information about maternal UTI diagnoses during pregnancy was received from the Hospital Discharge Register and the Medical Birth Register. UTIs were categorized as lower and upper UTIs according to the International Statistical Classification of Diseases and Related Health Problems (ICD)–10 diagnosis codes. Risks were calculated as odds ratios (OR) by logistic regression with 95% confidence intervals (CI) further adjusted for maternal characteristics (aOR). Finally, pregnancy‐pair analyses were performed: mothers who had changed smoking status (no smoking/any smoking) between consecutive pregnancies (n = 27 246 pregnancy‐pairs) were analyzed as one cluster and compared with non‐smokers. Results Smokers had UTIs more often compared with the non‐smokers. The association was even stronger among those who continued to smoke (aOR 1.60, 95% CI 1.51–1.70) than among those who smoked only during the first trimester (aOR 1.27, 95% CI 1.18–1.37) compared with non‐smokers. In pregnancy‐pair analysis, smoking was associated with upper UTIs during pregnancy (OR 1.49, 95% CI 1.05–2.12) compared with non‐smokers, but after the adjustments this association was attenuated (aOR 1.27, 95% CI 0.88–1.82). No association in lower UTIs was observed in the pregnancy‐pair design. Conclusions Maternal smoking was associated with a higher prevalence of UTIs during pregnancy in the standard comparison. The observed association was fully attenuated in the pregnancy‐pair analysis, in which smoking was dichotomized. This study suggests that the association between maternal smoking during pregnancy and adverse maternal health effects might be more complex than previously thought.https://doi.org/10.1111/aogs.14473nicotinepregnancypyelonephritissmokingurinary tract infection |
| spellingShingle | Hanna P. Wallin Mika Gissler Päivi E. Korhonen Mikael O. Ekblad New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study Acta Obstetricia et Gynecologica Scandinavica nicotine pregnancy pyelonephritis smoking urinary tract infection |
| title | New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study |
| title_full | New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study |
| title_fullStr | New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study |
| title_full_unstemmed | New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study |
| title_short | New insights into smoking and urinary tract infections during pregnancy using pregnancy‐pair design: A population‐based register study |
| title_sort | new insights into smoking and urinary tract infections during pregnancy using pregnancy pair design a population based register study |
| topic | nicotine pregnancy pyelonephritis smoking urinary tract infection |
| url | https://doi.org/10.1111/aogs.14473 |
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