Cigarette smoking and risk of gestational diabetes: A systematic review of observational studies

被引：27
作者：
Wendland E.M. [1 ]
Pinto M.E. [1 ]
Duncan B.B. [1 ]
Belizán J.M. [2 ]
Schmidt M.I. [1 ]
机构：
[1] Graduate Studies Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre
[2] Department of Mother and Child Health Research, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires
来源：
BMC Pregnancy and Childbirth | / 8卷 / 1期
关键词：
Cigarette Smoking; Gestational Diabetes Mellitus; Oral Glucose Tolerance Test; Gestational Diabetes; Gestational Weight Gain;
D O I：
10.1186/1471-2393-8-53
中图分类号：
学科分类号：
摘要：
Background: Gestational diabetes is a prevalent disease associated with adverse outcomes of pregnancy. Smoking as been associated with glucose intolerance during pregnancy in some but not all studies. Therefore, we aimed to systematically review all epidemiological evidence to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus. Methods: We conducted a systematic review of articles published up to 2007, using PubMed, Embase, LILACS e CINAHL to identify the articles. Because this review focuses on studies of smoking during pregnancy, we excluded studies evaluating smoking outside pregnancy. Two investigators independently abstracted information on participant's characteristics, assessment of exposure and outcome, and estimates for the association under study. We evaluated the studies for publication bias and performed heterogeneity analyses. We also assessed the effect of each study individually through sensitivity analysis. Results: We found and critically reviewed 32 studies, of which 12 met the criteria for inclusion in the review. Most of the studies provided only unadjusted measurements. Combining the results of the individual studies, we obtained a crude odds ratio of 1.03 (99% CI 0.85-1.25). Only 4 studies presented adjusted measurements of association, and no association was found when these alone were analyzed (OR 0.95; 99% CI 0.85-1.07). Subgroup analysis could not be done due to small sample size. Conclusion: The number of studies is small, with major heterogeneity in research design and findings. Taken together, current data do not support an association between cigarette smoking during pregnancy and the risk of gestational diabetes. © 2008 Wendland et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 77 条
  • [1] Metzger B.E., Coustan D.R., Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus, Diabetes Care, 21, SUPPL. 2, (1998)
  • [2] King H., Epidemiology of glucose intolerance and gestational diabetes in women of childbearing age, Diabetes Care, 21, SUPPL. 2, (1998)
  • [3] Schmidt M.I., Duncan B.B., Reichelt A.J., Branchtein L., Matos M.C., Et al., Gestational diabetes mellitus diagnosed with a 2-h 75-g oral glucose tolerance test and adverse pregnancy outcomes, Diabetes Care, 24, pp. 1151-1155, (2001)
  • [4] Dabelea D., Snell-Bergeon J.K., Hartsfield C.L., Bischoff K.J., Hamman R.F., McDuffie R.S., Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program, Diabetes Care, 28, pp. 579-584, (2005)
  • [5] Jarrett R.J., Castro-Soares J., Dornhorst A., Beard R.W., Castro-Soares J., Should we screen for gestational diabetes?, BMJ, 315, pp. 736-739, (1997)
  • [6] Sermer M., Naylor C.D., Farine D., Kenshole A.B., Ritchie J.W., Gare D.J., Et al., The Toronto Tri-Hospital Gestational Diabetes Project. A preliminary review, Diabetes Care, 21, SUPPL. 2, (1998)
  • [7] Jacob Reichelt A.A., Ferraz T.M., Rocha Oppermann M.L., Costa e F., Duncan B.B., Fleck P.E., Et al., Detecting glucose intolerance after gestational diabetes: Inadequacy of fasting glucose alone and risk associated with gestational diabetes and second trimester waist-hip ratio, Diabetologia, 45, pp. 455-457, (2002)
  • [8] Cheung N.W., Byth K., Population health significance of gestational diabetes, Diabetes Care, 26, pp. 2005-2009, (2003)
  • [9] Naylor C.D., Sermer M., Chen E., Farine D., Selective screening for gestational diabetes mellitus, N Engl J Med, 337, pp. 1591-1596, (1997)
  • [10] Davey R.X., Hamblin P.S., Selective versus universal screening for gestational diabetes mellitus: An evaluation of predictive risk factors, Med J Aust, 174, pp. 118-121, (2001)
12345678