Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 3 ( July-September, 2018 ) > List of Articles


Effects of Occupational Tobacco Exposure on Mother and Foetus in Beedi Rollers

Bharathi Rao, Sharadhi Channegowda, Prajwal Shetty, Divakar Rao

Keywords : Beedi rolling, Foetal growth restriction, Hypertension in pregnancy, Low birth weight, Tobacco exposure

Citation Information : Rao B, Channegowda S, Shetty P, Rao D. Effects of Occupational Tobacco Exposure on Mother and Foetus in Beedi Rollers. J South Asian Feder Obs Gynae 2018; 10 (3):209-214.

DOI: 10.5005/jp-journals-10006-1591

Published Online: 01-08-2015

Copyright Statement:  Copyright © 2018; The Author(s).


Background and objectives: Beedi rolling is a popular household occupation amongst the economically poor female population of coastal Karnataka districts. This study aimed to identify the effects of occupational tobacco exposure on the beedi rolling pregnant mother and her neonate. The objectives were to study the maternal outcomes with respect to hypertension in pregnancy, anemia, abruptio-placenta, preterm labor and the neonatal outcomes such as low birth weight, low appearance, pulse grimace, activity, respiration (APGAR) and clinical assessment of nutrition status (CANS) score. Methods: This prospective cohort study was conducted in a tertiary care hospital in Mangaluru from February 2014 to June 2015. A sample size of 500 was calculated with a 95% confidence level and 85% power. Cohort groups of 250 each were randomized as beedi rollers and non-beedi rollers based on the history of exposure and were prospectively followed till delivery. Results: The study results showed overall complications of 37.6 % among the beedi rollers which was clinically and statistically significant. Among the beedi rollers, 22.4% mothers had hypertension in pregnancy, of which 13.4%, had gestational hypertension, 8.2% pre-eclampsia, 0.4% had eclampsia, 27.6% were anaemic, and 9.6% had fetal growth restriction. There was no increase in the incidence of preterm labor, abrubtio-placenta. Our study also showed an increased risk of low birth weight (29.4%), but no significant difference in APGAR scores and CANS score among both groups. Based on the ROC curve we found, rolling 425 beedis can be taken as a safe limit during pregnancy with a sensitivity of 73.4% and specificity of 53.2% and 22 weeks period of gestation can be taken as safe limit up to which beedis can be rolled during pregnancy with a sensitivity of 61.7% and specificity of 64.1%. Clinical significance: In this study, dreadful complications can be attributed to beedi rolling. Majority of it can be prevented by health education and simple preventive measures such as using masks and gloves while rolling beedis for which further studies are warranted.

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  1. Sundaramoorthy R, Srinivasan V, Gujar J, Sen A, Sekar N, Abilash VG. Clinical, cytogenetic and CYP1A1 exon-1 gene mutation analysis of Beedi workers in Vellore region, Tamil Nadu. Asian Pac. J. Cancer Prev. 2014;14(12):7555-7560.
  2. Govekar RB, Bhisey RA. Elevated urinary thioether excretion among bidi rollers exposed occupationally to processed tobacco. Int Arch Occup Environ Health. 1992;64(2):101-104.
  3. George L, Granath F, Johansson AL, Annaren G, Cnattinqius S. Environmental tobacco smoke and risk of spontaneous abortion. Epidemiology. 2006;17(5):500-505.
  4. Chelmow D, Andrew DE, Baker ER. Maternal cigarette smoking and placenta previa. Obstet Gynecol. 1996;87(5 Pt 1): 703-706.
  5. Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J. Matern. Fetal. Neonatal. Med. 2003;13(3):175-190.
  6. Hung TH, Hsieh CC, Hsu JJ, Chiu TH, Lo LM, Hsieh TT. Risk factors for placenta previa in an Asian population. Int J Gynaecol Obstet. 2007;97(1):26-30.
  7. Ananth CV, Demissie K, Hanley ML. Birth weight discordancy and adverse perinatal outcomes among twin gestations in the United States: the effect of placental abruption. Am. J. Obstet. Gynecol. 2003;188(4):954-960.
  8. Fantuzzi G, Aggazzotti G, Righi E, Facchinetti F, Bertucci E, Kanitz S et al. Preterm delivery and exposure to active and passive smoking during pregnancy: a case-control study from Italy. Paediatr Perinat Epidemiol. 2007;21(3):194-200.
  9. Kolås T, Nakling J, Salvesen KA. Smoking during pregnancy increases the risk of preterm births among parous women. Acta Obstet Gynecol Scand. 2000;79(8):644-648.
  10. Högberg L, Cnattingius S. The influence of maternal smoking habits on the risk of subsequent stillbirth: is there a causal relation?. BJOG. 2007;114(6):699-704.
  11. Wisborg K, Kesmodel U, Henriksen TB, Olsen SF, Secher NJ. Exposure to tobacco smoke in utero and the risk of stillbirth and death in the first year of life. Am. J. Epidemiol. 2001;154 (4):322-327.
  12. Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M, Baumann P. Smoking in pregnancy revisited: findings from a large population-based study. Am. J. Obstet. Gynecol. 2005;192 (6):1856-1862.
  13. Nordentoft M, Lou HC, Hansen D, Nim J, Pryds O, Rubin P. Intrauterine growth retardation and premature deliv ery: the influence of maternal smoking and psychosocial factors. Am J Public Health. 1996;86(3):347-354.
  14. Bernstein IM, Mongeon JA, Badger GJ, Solomon L, Heil SH, Higgins ST. Maternal smoking and its association with birth weight. Obstet Gynecol. 2005;106 (5, Part 1): 986-991.
  15. Jaddoe VW, Troe EJ, Hofman A, Mackenbach JP, Moll HA, Steegers EA. Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study. Paediatr Perinat Epidemiol. 2008;22 (2):162-171.
  16. Mitchell EA, Milerad J. Smoking and the sudden infant death syndrome. Rev Environ Health. 2006;21(2):81-103.
  17. Mehta S, Tandon A, Dua T, Kumari S, Singh SK. Clinical assessment of nutritional status at birth. Indian Pediatr. 19 Hiralal Konar 99;35(5):423-428.
  18. Metcoff J. Clinical assessment of nutritional status at birth: Fetal malnutrition and SGA are not synonymous. Pediatr Clin North Am 1994;41:875-891.
  19. Fourn L, Ducic S, Seguin L. Smoking and intrauterine growth retardation in Republic of Benin. J Epidemiol Community Health [Internet]. 1999;53(7):432-433.
  20. Anil M, Machado L, Seqeuira A, Prasanna KS, Subramanya J. Study of morbidity pattern of female beedi workers in the urban field practice area of Mangalore, Southern India. 2012;(1):41-46.
  21. Ananth CV, Savitz DA, Luther ER. Maternal cigarette smoking as a risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy. Am. J. Epidemiol. 1996;144 (9): 881-889.
  22. Kyrklund-Blomberg NB, Cnattingius S. Preterm birth and maternal smoking: risks related to gestational age and onset of delivery. Am. J. Obstet. Gynecol. 1998;179(4):1051-1055.
  23. Shah NR, Bracken MB. A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am. J. Obstet. Gynecol. 2000;182(2):465-472.
  24. Sardesai Suman P, Shinde namdeo S, Patil shailesh B, rayate muktha N, Muley Bharath M. Tobacco handling by pregnant bidi workers : As hazardous as smoking during pregnancy. 2007;57(4):335-338.
  25. Rao VK, Morrison WA, O'Brien BM. Effect of nicotine on blood flow and patency of experimental microvascular anastomosis. Ann Plast Surg. 1983;11(3):206-209.
  26. Karumanchi SA, Levine RJ. How does smoking reduce the risk of preeclampsia?. Hypertension. 2010;55(5):1100-1101.
  27. Sreevidya Subramoney, prakash C gupta. Anemia in pregnant women who use smokeless tobacco. Nicotine Tob Res 2008;10(5):917-920.
  28. Egawa M, Yasuda K, Nakajima T Okada H, Yoshimura T, Yuri T. Smoking enhances oxytocin-induced rhythmic myometrial contraction. Biol. Reprod. 2002;68 (6): 2274-2280.
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