{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:48:29Z","timestamp":1790992109100,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008403","name":"Suomalainen L\u00e4\u00e4k\u00e4riseura Duodecim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008403","name":"Suomalainen L\u00e4\u00e4k\u00e4riseura Duodecim","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005930","name":"ASCRS Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005930","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pregnancy itself predisposes to urinary tract infections (UTI). There appears to be a higher prevalence of infections and genitourinary diseases among pregnant smokers than among non\u2010smokers. The present study is a retrospective observational register study aiming to investigate whether maternal smoking is associated with the prevalence of UTIs during pregnancy by utilizing a pregnancy\u2010pair analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Information about pregnancies and maternal smoking was obtained from the Finnish Medical Birth Register. The study sample consisted of all singleton pregnancies (<jats:italic>n<\/jats:italic>\u00a0=\u00a0723\u2009433) of women giving birth between January 2006 and December 2018 in Finland. Information on maternal smoking was collected in three categories: (1) non\u2010smoking; (2) quit smoking during the first trimester; and (3) continued smoking throughout the pregnancy. Information about maternal UTI diagnoses during pregnancy was received from the Hospital Discharge Register and the Medical Birth Register. UTIs were categorized as lower and upper UTIs according to the International Statistical Classification of Diseases and Related Health Problems (ICD)\u201310 diagnosis codes. Risks were calculated as odds ratios (OR) by logistic regression with 95% confidence intervals (CI) further adjusted for maternal characteristics (aOR). Finally, pregnancy\u2010pair analyses were performed: mothers who had changed smoking status (no smoking\/any smoking) between consecutive pregnancies (<jats:italic>n<\/jats:italic>\u00a0=\u00a027\u2009246 pregnancy\u2010pairs) were analyzed as one cluster and compared with non\u2010smokers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Smokers had UTIs more often compared with the non\u2010smokers. The association was even stronger among those who continued to smoke (aOR 1.60, 95% CI 1.51\u20131.70) than among those who smoked only during the first trimester (aOR 1.27, 95% CI 1.18\u20131.37) compared with non\u2010smokers. In pregnancy\u2010pair analysis, smoking was associated with upper UTIs during pregnancy (OR 1.49, 95% CI 1.05\u20132.12) compared with non\u2010smokers, but after the adjustments this association was attenuated (aOR 1.27, 95% CI 0.88\u20131.82). No association in lower UTIs was observed in the pregnancy\u2010pair design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal smoking was associated with a higher prevalence of UTIs during pregnancy in the standard comparison. The observed association was fully attenuated in the pregnancy\u2010pair analysis, in which smoking was dichotomized. This study suggests that the association between maternal smoking during pregnancy and adverse maternal health effects might be more complex than previously thought.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14473","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T07:21:08Z","timestamp":1666250468000},"page":"25-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["New insights into smoking and urinary tract infections during pregnancy using pregnancy\u2010pair design: A population\u2010based register study"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9616-8956","authenticated-orcid":false,"given":"Hanna P.","family":"Wallin","sequence":"first","affiliation":[{"name":"Department of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital  Turku Finland"},{"name":"KESSOTE Central Satakunta Health Federation of Municipalities  Harjavalta Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"THL Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Research Centre for Child Psychiatry University of Turku  Turku Finland"},{"name":"Academic Primary Health Care Centre Region Stockholm and Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi E.","family":"Korhonen","sequence":"additional","affiliation":[{"name":"Department of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael O.","family":"Ekblad","sequence":"additional","affiliation":[{"name":"Department of General Practice, Institute of Clinical Medicine University of Turku and Turku University Hospital  Turku Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"The Health Consequences of Smoking\u201450\u2009Years of Progress: A Report of the Surgeon General;2014. Accessed September 7 2021.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK294320\/"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2008.1024"},{"key":"e_1_2_11_4_1","first-page":"1","article-title":"Trends and characteristics of sexually transmitted infections during pregnancy: United States, 2016\u20102018","volume":"69","author":"Gregory ECW","year":"2020","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20540"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntz137"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0082932"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8398537"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/16.3.441"},{"key":"e_1_2_11_10_1","volume-title":"Urinary Tract Infection In Pregnancy","author":"Habak PJ","year":"2022"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8545(05)70219-9"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ucl.2015.05.004"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/427507"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073047"},{"issue":"387","key":"e_1_2_11_15_1","first-page":"e1","article-title":"Urinary tract infection during pregnancy, angiogenic factor profiles, and risk of preeclampsia","volume":"214","author":"Easter SR","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2165\/11538050-000000000-00000"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2019.1647524"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/87565640802564366"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/140349489502300113"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.47.3.242"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494812456637"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03729-1"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12333"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/nts147"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600935433"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2005.00660.x"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.06.016"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14473","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14473","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T16:39:03Z","timestamp":1743784743000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,20]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/aogs.14473"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14473","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,20]]},"assertion":[{"value":"2022-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}