{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:15:03Z","timestamp":1779934503427,"version":"3.53.1"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T00:00:00Z","timestamp":1495670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP 1041867"],"award-info":[{"award-number":["APP 1041867"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction and Aims.<\/jats:bold>To investigate the association between smokeless tobacco consumption (STC) during pregnancy and risk of stillbirth.<jats:bold>Design and Methods.<\/jats:bold>We conducted a population\u2010based case\u2013control study of 253 cases and 759 randomly selected control women in Madaripur, Bangladesh. We conducted a survey of two rural local government areas, including 8082 women, and identified cases based on self\u2010report of a stillbirth outcome of each participant's first pregnancy. All were asked about STC during their first pregnancy and a range of risk markers and known confounders. Demographic and maternal variables associated either with stillbirth or STC were included in logistic regression models.<jats:bold>Results.<\/jats:bold>Of the 241 cases and 757 controls with complete exposure data, 32 cases (13.2%) and 18 controls (2.4%) reported STC during pregnancy [odds ratio 6.28; 95% confidence interval (CI) 3.45, 11.4]. After adjustment for education, household income, age at first pregnancy, vaccination during pregnancy, complications, exposure to arsenic in drinking water, place of delivery and antenatal care, excess risk was attenuated but remained significant [adjusted odds ratio (aOR) 2.87; 95% CI 1.36, 6.08]. There was a dose\u2013effect association, with women who used smokeless tobacco &gt;5 times daily during their first pregnancy at greater risk of having a stillbirth (aOR 5.89; 95% CI 1.70, 20.3) than less frequent users (aOR 1.67; 95% CI 0.65, 4.29). Estimates were robust to extreme assumptions about missing exposure data.<jats:bold>Discussion and Conclusions.<\/jats:bold>STC during pregnancy was associated with an increased risk of stillbirth. This finding adds to the urgency of need for smokeless tobacco control strategies to be implemented in South Asia. [Hossain MS, Kypri K, Rahman B,Milton AH. Smokeless tobacco consumption and stillbirth: Population\u2010based case\u2013control study in rural Bangladesh.<\/jats:p>","DOI":"10.1111\/dar.12566","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T17:16:17Z","timestamp":1495732577000},"page":"414-420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Smokeless tobacco consumption and stillbirth: Population\u2010based case\u2013control study in rural Bangladesh"],"prefix":"10.1111","volume":"37","author":[{"given":"Mohammad Shakhawat","family":"Hossain","sequence":"first","affiliation":[{"name":"Saw Swee Hock School of Public Health National University of Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9657-9904","authenticated-orcid":false,"given":"Kypros","family":"Kypri","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health University of Newcastle Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bayzidur","family":"Rahman","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine University of New South Wales Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abul Hasnat","family":"Milton","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health University of Newcastle Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1016\/S2214-109X(13)70021-4","article-title":"Smokeless tobacco use by south Asians","volume":"2","author":"Siddiqi K","year":"2013","journal-title":"Lancet Glob Health"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1843.2003.00507.x"},{"key":"e_1_2_9_4_1","unstructured":"World Health Organization.Global adult tobacco survey: Bangladesh report 2009. 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