smoking during pregnancy is associated with a decreased incidence of obstetric anal sphincter injuries in nulliparous women怀孕期间吸烟与降低产科肛门括约肌损伤发病率未生育过的女性.pdf

Smoking during Pregnancy Is Associated with a Decreased Incidence of Obstetric Anal Sphincter Injuries in Nulliparous Women ¨ ¨ 1 ¨ 2,3 4,5 6,7 Sari Raisanen *, Katri Vehvilainen-Julkunen , Mika Gissler , Seppo Heinonen 1 Department of Nursing, Savonia University of Applied Sciences, Iisalmi, Finland, 2 Department of Nursing Science, University of Eastern Finland, Kuopio, Finland, 3 Research Unit, Kuopio University Hospital, Kuopio, Finland, 4 Information Department, Welfare and Health Data Resources Unit, National Institute for Health and Welfare, Helsinki, Finland, 5 Nordic School of Public Health, Gothenburg, Sweden, 6 Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland, 7 Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Abstract Background: Smoking is a modifiable lifestyle factor that has been shown to be associated with adverse perinatal outcomes and to have adverse health and dose-dependent connective tissue effects. The objective of this study was to examine whether smoking during pregnancy was associated with the incidence of obstetric anal sphincter injuries (OASIS) among six birthweight groups in singleton vaginal deliveries, considering nulliparous and multiparous women separately between 1997 and 2007 in Finland. Methodology: A retrospective population-based register study. Populations included women with spontaneous singleton vaginal deliveries, consisting of all 213,059 nulliparous and all 288,391 multiparous women. Incidence of OASIS (n = 2,787) between smoking status groups was adjusted using logistic regression analyses. Principal Findings: Of the nulliparous women, 13.1% were smokers, 3.6% had given u