Cigarette smoking during pregnancy in rural Nepal. Risk factors and effects of XXXX and @entity904 supplementation.

@entity1 @entity286 @entity410 @entity3556 @entity2066 @entity4 @entity904 @entity4793 @entity10
OBJECTIVE: We examined risk factors of smoking and the association between smoking and pregnancy-related and 6-month @entity1 mortality in rural Nepal, where 30% @entity1 reported smoking during pregnancy. DESIGN: Cross-sectional analysis of risk factors associated with smoking status and health consequences of smoking, using prospective data collected as part of a randomized community trial to examine the effect of maternal @entity904 or @entity2066 supplementation on maternal mortality. SETTING: Rural, southeastern plains of Nepal. SUBJECTS AND METHODS: A total of 17 767 @entity1 contributed at least one pregnancy during 3.5 y of the study. Data on cigarette or bidi (rolled @entity286 ) smoking were collected using a 7-day recall, twice during pregnancy. Associations between smoking status and maternal diet, morbidity profile, household socioeconomic status and serum concentration of @entity904 , carotenoids and @entity4793 were examined. Further, relative risk (RR) and 95% confidence intervals (CI) were calculated to estimate supplement effects on pregnancy-related mortality, stratified by smoking status during pregnancy. RESULTS: Smokers were more likely to be older, illiterate and poor compared to nonsmokers. Fruit and vegetable consumption among smokers and nonsmokers did not vary. However, smokers were more likely to consume meat/fish/eggs and less likely to consume milk than nonsmokers. They were also more likely to report symptoms of @entity3556 , @entity4 , severe @entity10 and @entity410 during pregnancy relative to nonsmokers. Mortality per 100,000 pregnancies appeared to be higher among smokers than nonsmokers in the placebo group (915 vs 584, RR=1.57, 95% CI: 0.80-3.08). @entity2066 supplementation reduced pregnancy-related mortality both among smokers (RR=0.31 95% CI: 0.11-0.89) and nonsmokers (RR=0.41, 95% CI: 0.19-0.89). Similar results obtained with @entity904 supplementation were not statistically significant. @entity1 mortality up to 6 months was approximately 30% higher among smokers compared to nonsmokers in the placebo group both before and after adjusting for confounding factors. Neither supplement given to @entity1 reduced @entity1 mortality. CONCLUSIONS: Cigarette smoking during pregnancy is associated with an increased risk of maternal and @entity1 mortality in rural Nepal. @entity2066 and to some extent @entity904 may reduce the risk of pregnancy-related mortality, but not @entity1 mortality, among both smokers and nonsmokers.
