smoking in preeclamptic women is associated with higher birthweight for gestational age and lower soluble fms-like tyrosine kinase-1 levels a nested case control study在preeclamptic女性吸烟与更高的胎龄和出生体重低可溶性fms-like酪氨酸激酶1嵌套病例对照研究的水平.pdfVIP

Kahn et al. BMC Pregnancy and Childbirth 2011, 11:91 /1471-2393/11/91 RESEARCH ARTICLE Open Access Smoking in preeclamptic women is associated with higher birthweight for gestational age and lower soluble fms-like tyrosine kinase-1 levels: a nested case control study 1* 2 3 5 1 4 Susan R Kahn , Nisha D Almeida , Helen McNamara , Gideon Koren , Jacques Genest Jr , Mourad Dahhou , Robert W Platt2,4 and Michael S Kramer2,4 Abstract Background: Smoking paradoxically increases the risk of small-for-gestational-age (SGA) birth but protects against preeclampsia. Some studies have reported a “U-shaped” distribution of fetal growth in preeclamptic pregnancies, but reasons for this are unknown. We investigated whether cigarette smoking interacts with preeclampsia to affect fetal growth, and compared levels of soluble fms-like tyrosine kinase-1 (sFlt-1), a circulating anti-angiogenic protein, in preeclamptic smokers and non-smokers. Methods: From a multicenter cohort of 5337 pregnant women, we prospectively identified 113 women who developed preeclampsia (cases) and 443 controls. Smoking exposure was assessed by self-report and maternal hair nicotine levels. Fetal growth was assessed as z-score of birthweight for gestational age (BWGA). sFlt-1 was measured in plasma samples collected at the 24-26-week visit. Results: In linear regression, smoking and preeclampsia were each associated with lower BWGA z-scores (b = -0.29; p = 0.008, and b = -0.67; p 0.0001), but positive interaction was observed between smoking and preeclampsia (b = +0.86; p = 0.0008) such that smoking decreased z-score by -0.29 in controls but increased it by +0.57 in preeclampsia cases. Results were robust to substituting log hair nicot