{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:18Z","timestamp":1787013858683,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,29]],"date-time":"2013-03-29T00:00:00Z","timestamp":1364515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the potential effects of prenatal smokeless tobacco use on selected birth outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A population\u2010based, case\u2013control study using a retrospective medical record review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Singleton deliveries 1997\u20132005 to Alaska Native women residing in western Alaska.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Hospital discharge codes were used to identify potential case deliveries and a random control sample. Data on tobacco use and confirmation of pregnancy outcomes were abstracted from medical records for 1123 deliveries. Logistic regression was used to examine associations between tobacco use and pregnancy outcomes. Adjusted odds ratios (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ), 95% confidence intervals (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ), and\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measures<\/jats:title>\n                    <jats:p>Preterm delivery, pregnancy\u2010associated hypertension, and placental abruption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In unadjusted analysis, smokeless tobacco use was not significantly associated with preterm delivery (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.44, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.97\u20132.15). After adjustment for parity, pre\u2010pregnancy body mass index, and maternal age, the point estimate was attenuated and remained non\u2010significant. No significant associations were observed between smokeless tobacco use and pregnancy\u2010associated hypertension (adjusted\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      0.92, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.56\u20131.51) or placental abruption (adjusted\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.11, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.53\u20132.33).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prenatal smokeless tobacco use does not appear to reduce risk of pregnancy\u2010associated hypertension or to substantially increase risk of abruption. An association between smokeless tobacco and preterm delivery could not be ruled out. Components in tobacco other than nicotine likely play a major role in decreased pre\u2010eclampsia risk in smokers. Nicotine adversely affects fetal neurodevelopment and our results should not be construed to mean that smokeless tobacco use is safe during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.12124","type":"journal-article","created":{"date-parts":[[2013,3,29]],"date-time":"2013-03-29T06:34:43Z","timestamp":1364538883000},"page":"648-655","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Effects of maternal smokeless tobacco use on selected pregnancy outcomes in Alaska Native women: a case\u2013control study"],"prefix":"10.1111","volume":"92","author":[{"given":"Lucinda J.","family":"England","sequence":"first","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin Y.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie K.","family":"Shapiro\u2010Mendoza","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoyt G.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette S.","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen A.","family":"Satten","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire A.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Yukon Kuskokwim Health Corporation Bethel Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra J.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Callaghan","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health Centers for Disease Control and Prevention Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/siny.2000.0025"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2741\/2248"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2001.00918.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-3-37"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38113.687882.EB"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000190545.19168.c4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)00661-6"},{"key":"e_1_2_9_9_1","first-page":"1","article-title":"Global youth tobacco surveillance, 2000\u20132007","volume":"57","author":"Warren CW","year":"2008","journal-title":"MMWR Surveill Summ"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0402-9"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5993\/AJHB.29.6.13"},{"key":"e_1_2_9_12_1","unstructured":"U.S. Department of Health and Human Services 2010 U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health Atlanta GA"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70240-7"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02575.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2006.00707.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.148973"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.147082"},{"key":"e_1_2_9_18_1","unstructured":"State of California Environmental Protection Agency Office of Environmental Health Hazard Assessment.Safe drinking water and toxic enforcement act of 1986. 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