Smokeless Tobacco Use Doubles Risk of Stillbirth

Risk similar to that of cigarette smoking

FRIDAY, Dec. 30 (HealthDay News) -- Smokeless tobacco use during pregnancy more than doubles the risk of stillbirth and is just as risky as maternal cigarette smoking, researchers report in the January issue of Epidemiology. The study was conducted in India, where women use smokeless tobacco in the form of mishri, a product used as a toothpaste.

Prakash C. Gupta, Sc.D., and Sreevidya Subramoney of the Tata Institute of Fundamental Research in Mumbai, studied 1,217 women in the city of Mumbai who were three to seven months pregnant. Ninety-six percent of the women were contacted again after delivery to determine the number of stillbirths, defined as the delivery of a dead fetus after 20 weeks gestation.

Overall, 206 of the 1,217 women (17%) reported using smokeless tobacco. The rate of stillbirth among singleton pregnancies was 4.1%. Overall, 3% of women who did not use tobacco had a stillbirth compared with 8.9% of women who used smokeless tobacco. After taking age, education, socioeconomic background, working status, parity, prenatal care and place of delivery into account, the risk of stillbirth was 2.6 times higher in smokeless tobacco users than in nonusers. The risk of stillbirth was higher earlier in gestation, and there was a dose-response relationship between the risk of stillbirth and frequency of mishri use, according to the study.

"Smokeless tobacco use during pregnancy increases stillbirth risk, with a risk at least as great as that associated with maternal cigarette smoking," the researchers conclude.

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