Meta Analisis Merokok dalam Kehamilan Secara Paradoks Dikaitkan dengan Penurunan Risiko Preeklamsia
Abstract
Meskipun merokok selama kehamilan dapat menyebabkan hasil yang merugikan, banyak penelitian telah melaporkan hubungan terbalik paradoks antara ibu yang merokok selama kehamilan dan preeklamsia. Studi ini bertujuan untuk mengetahui risiko merokok dalam kehamilan terhadap preeklamsia. Penelitian ini merupakan meta analisis menggunakan PRISMA. Pencarian basis data dilakukan 2011–2021. 12 dari 1.056 studi masuk dalam kriteria untuk dianalisis. Penyajian data menggunakan forest plot dengan model statistik random effect. Besar odds ratio (OR) gabungan menunjukkan bahwa merokok dalam kehamilan menurunkan risiko preeklamsia sebesar 0.77 kali lebih rendah dibanding ibu yang tidak merokok (AOR: 0.84; CI: 0.74-0.95; p< 0,001). Heteroginitas tinggi 73%, secara statistik signifikan dan funnel plot menunjukan tidak ada bias publikasi. Terdapat bukti bahwa merokok dalam kehamilan berbanding terbalik terhadap risiko terjadinya preeklamsia, namun bukti juga menunjukan merokok dapat beresiko komplikasi berbagai penyakit dalam kehamilan.
References
Anderson, N. H., Sadler, L. C., Stewart, A. W., Fyfe, E. M., & McCowan, L. M. E. (2012a). Ethnicity, body mass index and risk of pre-eclampsia in a multiethnic New Zealand population. Australian and New Zealand Journal of Obstetrics and Gynaecology, 52(6), 552–558. https://doi.org/10.1111/j.1479-828X.2012.01475.x.
Anderson, N. H., Sadler, L. C., Stewart, A. W., Fyfe, E. M., & McCowan, L. M. E. (2012b). Ethnicity, body mass index and risk of pre-eclampsia in a multiethnic New Zealand population. Australian and New Zealand Journal of Obstetrics and Gynaecology, 52(6), 552–558. https://doi.org/10.1111/j.1479-828X.2012.01475.x.
Atmojo, J. T., Soemanto, R. B., & Murti, B. (2017). Determinants of successful smoking cessation in Surakarta, Central Java. Journal of Health Promotion and Behavior, 2(4), 332-342. https://doi.org/10.26911/thejhpb.2017.02.04.05.
Bartnik, P., Kosinska-Kaczynska, K., Kacperczyk, J., Ananicz, W., Sierocińska, A., Wielgos, M., & Szymusik, I. (2016). Twin Chorionicity and the Risk of Hypertensive Disorders: Gestational Hypertension and Pre-eclampsia. Twin Research and Human Genetics, 19(4), 377–382. https://doi.org/10.1017/thg.2016.17.
Bartsch, E., Medcalf, K. E., Park, A. L., Ray, J. G., Al-Rubaie, Z. T. A., Askie, L. M., Berger, H., Blake, J., Graves, L., Kingdom, J. C., Lebovic, G., Lord, S. J., Maguire, J. L., Mamdani, M. M., Meloche, J., Urquia, M. L., & Van Wagner, V. (2016). Clinical risk factors for pre-eclampsia determined in early pregnancy: Systematic review and meta-analysis of large cohort studies. The BMJ, 353. https://doi.org/10.1136/bmj.i1753.
Brown, M. A., Magee, L. A., Kenny, L. C., Karumanchi, S. A., McCarthy, F. P., Saito, S., Hall, D. R., Warren, C. E., Adoyi, G., & Ishaku, S. (2018). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. In Pregnancy Hypertension (Vol. 13, pp. 291–310). Elsevier B.V. https://doi.org/10.1016/j.preghy.2018.05.004.
CDC. (n.d.). Tekanan Darah Tinggi Selama Kehamilan | cdc.gov. Retrieved July 1, 2021, from https://www.cdc.gov/bloodpressure/pregnancy.htm.
Cleary; Eogan; Sheehan. (2016). Oral contraceptive induced hypert... preview & related info | Mendeley. Pharmacoepidemiology and Drug Safety. https://www.mendeley.com/catalogue/9de6c55a-6f60-39ec-b68c-0097dd1a1454/.
D, P., AA, P., S, S., & D, M. (2019). Effects of maternal smoking on human placental vascularization: A systematic review. Taiwanese Journal of Obstetrics & Gynecology, 58(4), 454–459. https://doi.org/10.1016/J.TJOG.2019.05.004.
Diaz-Santana, M. V., O’Brien, K. M., D’Aloisio, A. A., Regalado, G., Sandler, D. P., & Weinberg, C. R. (2020). Perinatal and postnatal exposures and risk of young-onset breast cancer. Breast Cancer Research, 22(1). https://doi.org/10.1186/s13058-020-01317-3.
Egeland, G. M., Klungsøyr, K., Øyen, N., Tell, G. S., Næss, Ø., & Skjærven, R. (2016). Preconception cardiovascular risk factor differences between gestational hypertension and preeclampsia: Cohort Norway study. Hypertension, 67(6), 1173–1180. https://doi.org/10.1161/HYPERTENSIONAHA.116.07099.
EIDS, M., BA, S., NP, L., & BL, H. (2019). Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis. Cadernos de Saude Publica, 35(12), e00176118. https://doi.org/10.1590/0102-311X00176118.
Endeshaw, M., Abebe, F., Worku, S., Menber, L., Assress, M., & Assefa, M. (2016). Obesity in young age is a risk factor for preeclampsia: A facility based case-control study, northwest Ethiopia. BMC Pregnancy and Childbirth, 16(1). https://doi.org/10.1186/s12884-016-1029-2.
Handayani, R. T., Widiyanto, A., Atmojo, J. T., & Setyorini, C. (2020). Effect of Antenatal Mental Health Disorder on Fetal Growth: A Systematic Review. Journal of Maternal and Child Health, 5(2), 147-153. https://doi.org/10.26911/thejmch.2020.05.02.04.
Jääskeläinen, T., Heinonen, S., Hämäläinen, E., Pulkki, K., Romppanen, J., Laivuori, H., Laivuori, H., Heinonen, S., Kajantie, E., Kere, J., Kivinen, K., & Pouta, A. (2019). Impact of obesity on angiogenic and inflammatory markers in the Finnish Genetics of Pre-eclampsia Consortium (FINNPEC) cohort. International Journal of Obesity, 43(5), 1070–1081. https://doi.org/10.1038/s41366-018-0217-8.
Jeyabalan, Powers, Durica, Harger, Roberts, & Ness. (2008). Cigarette smoke exposure and angiogenic factors in pregnancy and preeclampsia. American Journal of Hypertension, 21(8), 943–947. https://doi.org/10.1038/AJH.2008.219.
K, H., SY, Z., & BM, S. (2019). The influence of maternal body mass index, maternal diabetes mellitus, and maternal smoking during pregnancy on the risk of childhood-onset type 1 diabetes mellitus in the offspring: Systematic review and meta-analysis of observational studies. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 20(8), 1106–1120. https://doi.org/10.1111/OBR.12858.
Khalil, A., Syngelaki, A., Maiz, N., Zinevich, Y., & Nicolaides, K. H. (2013a). Maternal age and adverse pregnancy outcome: A cohort study. Ultrasound in Obstetrics and Gynecology, 42(6), 634–643. https://doi.org/10.1002/uog.12494.
Khalil, A., Syngelaki, A., Maiz, N., Zinevich, Y., & Nicolaides, K. H. (2013b). Maternal age and adverse pregnancy outcome: A cohort study. Ultrasound in Obstetrics and Gynecology, 42(6), 634–643. https://doi.org/10.1002/uog.12494.
Laine, K., Murzakanova, G., Sole, K. B., Pay, A. D., Heradstveit, S., & Raïsänen, S. (2019a). Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: A population-based register study. BMJ Open, 9(7). https://doi.org/10.1136/bmjopen-2019-029908.
Laine, K., Murzakanova, G., Sole, K. B., Pay, A. D., Heradstveit, S., & Raïsänen, S. (2019b). Prevalence and risk of pre-eclampsia and gestational hypertension in twin pregnancies: A population-based register study. BMJ Open, 9(7). https://doi.org/10.1136/bmjopen-2019-029908.
Leaños-Miranda, Campos-Galicia, Isordia-Salas, Rivera-Leaños, Ayala-Méndez, R.-A., & Ulloa-Aguirre. (2012). Changes in circulating concentrations of soluble fms-like tyrosine kinase-1 and placental growth factor measured by automated electrochemiluminescence immunoassays methods are predictors of preeclampsia. Journal of Hypertension, 30(11), 2173–2181. https://doi.org/10.1097/HJH.0B013E328357C0C9.
Lewandowska, M., & Więckowska, B. (2020). The Influence of Various Smoking Categories on The Risk of Gestational Hypertension and Pre-Eclampsia. Journal of Clinical Medicine, 9(6), 1743. https://doi.org/10.3390/jcm9061743.
Lisonkova, S., Razaz, N., Sabr, Y., Muraca, G. M., Boutin, A., Mayer, C., Joseph, K. S., & Kramer, M. S. (2020). Maternal risk factors and adverse birth outcomes associated with HELLP syndrome: a population-based study. BJOG: An International Journal of Obstetrics and Gynaecology, 127(10), 1189–1198. https://doi.org/10.1111/1471-0528.16225.
Meazaw, M. W., Chojenta, C., Muluneh, M. D., & Loxton, D. (2020). Systematic and meta-analysis of factors associated with preeclampsia and eclampsia in sub-Saharan Africa. PLoS ONE, 15(8 August). https://doi.org/10.1371/journal.pone.0237600.
N, R., R, D., DS, A., M, K., N, B., & R, K. (2010). Role of oxidative stress markers and antioxidants in the placenta of preeclamptic patients. The Journal of Obstetrics and Gynaecology Research, 36(6), 1189–1194. https://doi.org/10.1111/J.1447-0756.2010.01303.X.
O’Brien, L. M., Bullough, A. S., Owusu, J. T., Tremblay, K. A., Brincat, C. A., Chames, M. C., Kalbfleisch, J. D., & Chervin, R. D. (2012). Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: Prospective cohort study. American Journal of Obstetrics and Gynecology, 207(6), 487.e1-487.e9. https://doi.org/10.1016/j.ajog.2012.08.034.
Osungbade, K. O., & Ige, O. K. (2011). Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening. Journal of Pregnancy, 2011, 481095. https://doi.org/10.1155/2011/481095.
Perni, U. C., Wikström, A. K., Cnattingius, S., & Villamor, E. (2012). Interpregnancy change in smoking habits and risk of preeclampsia: A population-based study. American Journal of Hypertension, 25(3), 372–378. https://doi.org/10.1038/ajh.2011.225.
Perry, H., Sheehan, E., Thilaganathan, B., & Khalil, A. (2018). Home blood-pressure monitoring in a hypertensive pregnant population. Ultrasound in Obstetrics and Gynecology, 51(4), 524–530. https://doi.org/10.1002/uog.19023.
Phipps, E. A., Thadhani, R., Benzing, T., & Karumanchi, S. A. (2019). Pre-eclampsia: pathogenesis, novel diagnostics and therapies. In Nature Reviews Nephrology (Vol. 15, Issue 5, pp. 275–289). Nature Publishing Group. https://doi.org/10.1038/s41581-019-0119-6.
Robillard, P. Y., Dekker, G., Scioscia, M., Bonsante, F., Iacobelli, S., Boukerrou, M., & Hulsey, T. C. (2020). The blurring boundaries between placental and maternal preeclampsia: a critical appraisal of 1800 consecutive preeclamptic cases. Journal of Maternal-Fetal and Neonatal Medicine. https://doi.org/10.1080/14767058.2020.1786516.
S, T., TJ, K.-L., K, O., S, B., R, H., NK, B., C, C., L, T., C, W., F, B., M, D. S., & NJ, H. (2015). Heme Oxygenase-1 Is Not Decreased in Preeclamptic Placenta and Does Not Negatively Regulate Placental Soluble fms-Like Tyrosine Kinase-1 or Soluble Endoglin Secretion. Hypertension (Dallas, Tex. : 1979), 66(5), 1073–1081. https://doi.org/10.1161/HYPERTENSIONAHA.115.05847
Tandberg, A., Klungsøyr, K., Romundstad, L. B., & Skjærven, R. (2015). Pre-eclampsia and assisted reproductive technologies: Consequences of advanced maternal age, interbirth intervals, new partner and smoking habits. BJOG: An International Journal of Obstetrics and Gynaecology, 122(7), 915–922. https://doi.org/10.1111/1471-0528.13051.
Wang, J., Yang, W., Xiao, W., & Cao, S. (2021). The association between smoking during pregnancy and hypertensive disorders of pregnancy: A systematic review and meta-analysis. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/IJGO.13709.
Wang, K., Zhou, Q., He, Q., Tong, G., Zhao, Z., & Duan, T. (2011). The possible role of AhR in the protective effects of cigarette smoke on preeclampsia. Medical Hypotheses, 77(5), 872–874. https://doi.org/10.1016/j.mehy.2011.07.061.
Wei, J., Liu, C. X., Gong, T. T., Wu, Q. J., & Wu, L. (2015a). Cigarette smoking during pregnancy and preeclampsia risk: A systematic review and meta-analysis of prospective studies. Oncotarget, 6(41), 43667–43678. https://doi.org/10.18632/oncotarget.6190.
Wei, J., Liu, C. X., Gong, T. T., Wu, Q. J., & Wu, L. (2015b). Cigarette smoking during pregnancy and preeclampsia risk: A systematic review and meta-analysis of prospective studies. Oncotarget, 6(41), 43667–43678. https://doi.org/10.18632/oncotarget.6190.