Abstract:
BACKGROUND:While associations of smoking and preterm birth (PTB) with maternal cardiovascular disease (CVD) risks have been established, it is unknown whether the coexistence of these two conditions could synergistically increase the risks. METHODS:We linked birth records of 902,008 mothers with singleton infants during 1994-2011 in New South Wales, Australia to the mothers' subsequent CVD hospitalisation or death. Multiplicative interaction was tested through an interaction term in a multivariate Cox-proportional hazard regression model, while additive interaction was assessed by calculating the synergy index. RESULTS:Relative to never-smokers with term babies, the CVD risk in ever-smokers with PTBs (hazard ratio (HR) 3.35, 95% confidence interval (CI) 2.96-3.80) was significantly greater than the sum of risks in ever-smokers with term babies (HR 2.10, 95% CI 1.96-2.24) and in never-smokers with PTBs (HR 1.73, 95% CI 1.55-1.93), indicating an additive interaction (synergy index = 1.29, 95% CI 1.05-1.58). In ever-smokers, the association was stronger for extremely PTB (HR 3.83, 95% CI 3.23-4.69) than moderately PTB (HR 3.18, 95% CI 2.76-3.66), and for ≥2 PTB (HR 4.47, 95% CI 3.39-5.88) than one PTB (HR 3.20, 95% CI 2.81-3.64). CONCLUSION:Maternal smoking and PTB interact on the additive scale to synergistically increase maternal CVD risks. The interaction was dose-dependent according to both the severity and number of PTBs.
journal_name
Eur J Prev Cardioljournal_title
European journal of preventive cardiologyauthors
Ngo AD,Roberts CL,Chen JS,Figtree Gdoi
10.1177/2047487315593836subject
Has Abstractpub_date
2016-04-01 00:00:00pages
613-20issue
6eissn
2047-4873issn
2047-4881pii
2047487315593836journal_volume
23pub_type
杂志文章abstract:BACKGROUND:In order to improve national cardiovascular disease (CVD) epidemiology and prevention, we systematically reviewed and analyzed the relevant literature produced in the last three decades for Spain. DESIGN:Systematic Review. METHODS:We searched for all the articles aiming to monitor CVD clinical endpoints an...
journal_title:European journal of preventive cardiology
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journal_title:European journal of preventive cardiology
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,多中心研究
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