{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:20:17Z","timestamp":1774570817410,"version":"3.50.1"},"reference-count":60,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,8,23]]},"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A multicentre hospital-based case\u2013control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Four leading maternity hospitals of Karachi.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48\u2005hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, low Apgar score) and obstetric complications (antepartum haemorrhage, caesarean section, etc).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Final multiple logistic regression analysis revealed that with every 1\u2005year increase in age the odds of being a case was 1.03 times as compared with being a control. Tobacco use (adjusted OR (aOR): 2.24; 95% CI 1.56 to 3.23), having no slits in the kitchen (proxy indicator for indoor air pollution) (aOR=1.90; 95% CI 1.05 to 3.43), gravidity (aOR=0.83; 95% CI 0.73 to 0.93), non-booked hospital cases (aOR=1.87; 95% CI 1.38 to 2.74), history of stillbirth (aOR=4.06; 95% CI 2.36 to 6.97), miscarriages (aOR=1.91; 95% CI 1.27 to 2.85) and preterm delivery (aOR=6.04; 95% CI 2.52 to 14.48) were significantly associated with being a case as compared with control.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study suggests that women who had adverse pregnancy outcomes were more likely to have exposure to tobacco, previous history of adverse birth outcomes and were non-booked cases. Engagement of stakeholders in tobacco control for providing health education, incorporating tobacco use in women in the tobacco control policy and designing interventions for tobacco use cessation is warranted. Prenatal care and health education might help in preventing such adverse events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012045","type":"journal-article","created":{"date-parts":[[2016,9,20]],"date-time":"2016-09-20T22:48:51Z","timestamp":1474411731000},"page":"e012045","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Association of tobacco use and other determinants with pregnancy outcomes: a multicentre hospital-based case\u2013control study in Karachi, Pakistan"],"prefix":"10.1136","volume":"6","author":[{"given":"Shafquat","family":"Rozi","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahid Ahmad","family":"Butt","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nida","family":"Zahid","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba","family":"Wasim","sequence":"additional","affiliation":[{"name":"Faculty of Biostatistics, College of Science and Health Professions, King Saud Bin Abdulaziz University, Riyadh, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kashif","family":"Shafique","sequence":"additional","affiliation":[{"name":"School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan"},{"name":"Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,9,20]]},"reference":[{"key":"2025101814075889000_6.9.e012045.1","first-page":"4","article-title":"Socio-biological determinants of low birth weight: a community based study from rural field practice area of Medical College, Kolkata, West Bengal (India)","volume":"201","author":"Manna","year":"2013","journal-title":"IOSR J Dent Med Sci"},{"key":"2025101814075889000_6.9.e012045.2","unstructured":"Wardlaw TM . 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