Partner’s dual use of new tobacco products and combustible cigarettes in early pregnancy was associated with hypertensive disorders of pregnancy: a cross-sectional study

It is an urgent issue to clarify whether new tobacco products have adverse pregnancy effects. As far as we know, however, there is no study of the association between passive smoking by new tobacco products and pregnancy complications, including hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM). We explored the association between partner’s smoking at home during early pregnancy as an indicator of passive smoking and pregnancy complications. Participants were recruited from 16 obstetric clinics and hospitals within seven Japanese regions from December 2019 to March 2023 and answered a self-administered questionnaire. Among them, we conducted a cross-sectional analysis of 1354 postpartum women who did not smoke during early pregnancy. We categorized the participants into four groups based on their partner’s smoking status: dual users (combustible cigarettes and new tobacco products), new tobacco product-only users, combustible cigarette-only users, and non-smokers at home (reference). We performed Firth’s penalized logistic regression analysis and estimated the odds ratio (OR) of HDP and GDM diagnosis. The majority of partners were non-smokers (85.4%), followed by new tobacco product-only users (7.2%), dual users (4.4%), and combustible cigarette-only users (2.9%). The prevalence of HDP and GDM was 3.2% and 6.3%, respectively. For women whose partners were dual users, the multivariable-adjusted OR of HDP was 4.54 (95% confidence interval, 1.60–12.82). There was no association between partner’s smoking status and GDM. We found an association between the partner’s dual use of new tobacco products and combustible cigarettes in early pregnancy and HDP.