Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey

Yoshihiko Hosokawa; Masayoshi Zaitsu; Sumiyo Okawa; Naho Morisaki; Ai Hori; Yukiko Nishihama; Shoji F Nakayama; Takeo Fujiwara; Hiromi Hamada; Toyomi Satoh; Takahiro Tabuchi

doi:10.3390/ijerph191811826

Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey

Int J Environ Res Public Health. 2022 Sep 19;19(18):11826. doi: 10.3390/ijerph191811826.

Authors

Affiliations

¹ Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8577, Japan.
² Center for Research of the Aging Workforce, University of Occupational and Environmental Health, Kitakyushu 807-8556, Japan.
³ Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
⁴ Department of Social Medicine, National Center for Child Health and Development, Tokyo 157-8535, Japan.
⁵ Department of Global Public Health, University of Tsukuba, Tsukuba 305-8577, Japan.
⁶ Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba 305-8506, Japan.
⁷ Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
⁸ Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan.

Abstract

Combustible cigarette smoking impacts fetal growth during pregnancy. However, the risk associated with heated tobacco products (HTPs) remains unclear. This nationwide cross-sectional study investigated whether HTP use during pregnancy is associated with small for gestational age (SGA) outcomes among 5647 post-delivery women with singleton pregnancies, which were divided into four groups: lifetime never-smokers, former smokers before pregnancy, and current smokers for each of the tobacco products during pregnancy (sole HTP and sole combustion smokers). Information on the prevalence of SGA, defined as birth weight and height below the 10th percentile, was retrieved from the Maternal and Child Health Handbooks of post-delivery women. Using logistic regression, the association between sole HTP smokers during pregnancy and SGA, adjusted for covariates, with lifetime never-smokers as reference, was investigated. The prevalence was: current sole HTP smokers during pregnancy, 1.8% (102/5647); and SGA, 2.9% (164/5647). Sole HTP smokers during pregnancy had a higher prevalence of SGA (5.9% [6/102] vs. 2.7% [111/4144]) with an adjusted odds ratio (OR) of 2.50 (95% confidence interval [CI], 1.03-6.05) than lifetime never-smokers. Among sole combustion smokers, the adjusted OR for SGA was 1.95 (95% CI, 0.81-4.67). In Japan, HTP smoking during pregnancy may be associated with an increased risk for SGA.

Keywords: coronavirus disease 2019; heated tobacco products; perinatal outcome; small for gestational age; smoking.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Cross-Sectional Studies
Female
Fetal Development*
Fetal Growth Retardation / epidemiology
Fetal Growth Retardation / etiology
Humans
Internet
Japan / epidemiology
Pregnancy
Tobacco Products*

Grants and funding

This research was funded by the Japan Society for the Promotion of Science KAKENHI Grants [grant number JP 21H04856]; the Japan Science and Technology Agency [grant number JPMJSC21U6]; Intramural fund of the National Institute for Environmental Studies; Innovative Research Program on Suicide Countermeasures [grant number R3-2-2]; Ready for COVID-19 Relief Fund [grant number 5th period 2nd term 001]; and the Ministry of Health, Labour, and Welfare (Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus Grants [grant number 20FA1005]). The findings and conclusions of this article are the sole responsibility of the authors and do not represent the official views of the research funders.