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Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland

BACKGROUND AND PURPOSE: Smoking weakens bone health and increases the risk of fractures. We investigated the incidence of fractures in smoking, fertile-aged women and compared it with that of non-smoking, fertile-aged women using data from nationwide registers. PATIENTS AND METHODS: We conducted a r...

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Autores principales: VAAJALA, Matias, KUITUNEN, Ilari, NYRHI, Lauri, PONKILAINEN, Ville, HUTTUNEN, Tuomas T, MATTILA, Ville M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703666/
https://www.ncbi.nlm.nih.gov/pubmed/36440602
http://dx.doi.org/10.2340/17453674.2022.5275
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author VAAJALA, Matias
KUITUNEN, Ilari
NYRHI, Lauri
PONKILAINEN, Ville
HUTTUNEN, Tuomas T
MATTILA, Ville M
author_facet VAAJALA, Matias
KUITUNEN, Ilari
NYRHI, Lauri
PONKILAINEN, Ville
HUTTUNEN, Tuomas T
MATTILA, Ville M
author_sort VAAJALA, Matias
collection PubMed
description BACKGROUND AND PURPOSE: Smoking weakens bone health and increases the risk of fractures. We investigated the incidence of fractures in smoking, fertile-aged women and compared it with that of non-smoking, fertile-aged women using data from nationwide registers. PATIENTS AND METHODS: We conducted a retrospective register-based nationwide cohort study from 1998 to 2018. We identified all women smoking during pregnancy from the Medical Birth Register and compared these with non-smokers. We gathered fractures for both groups from the Care Register for Health Care. Pregnancies with missing smoking or socioeconomic status were excluded. A Cox regression model was used to analyze adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for fractures during the 5-year follow-up starting from delivery. The model was adjusted for the age of the mother at the time of delivery and socioeconomic status. RESULTS: The smoking group included 110,675 pregnancies and the non-smoking group 628,085 pregnancies. The overall fracture rate was higher in smokers after 1-year follow-up (aHR 1.7, CI 1.5–2.0) and 5-year follow-up (aHR 1.7, CI 1.6–1.8). After 5-year follow-up, the fracture rates for polytraumas (aHR 2.3, CI 1.4–3.7), inpatient admitted fractures (aHR 2.0, CI 1.7–2.4), and non-admitted fractures (aHR 1.8, CI 1.7–1.9) were all higher among smoking women. CONCLUSION: Smoking in fertile-aged women was associated with a higher risk of fractures during the 1-year and 5-year follow-up after giving birth, also after adjusting for age and socioeconomic status. Whether the increased fracture risk is caused by direct effects of smoking on bone health or riskier behavior remains uncertain.
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spelling pubmed-97036662022-11-28 Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland VAAJALA, Matias KUITUNEN, Ilari NYRHI, Lauri PONKILAINEN, Ville HUTTUNEN, Tuomas T MATTILA, Ville M Acta Orthop Article BACKGROUND AND PURPOSE: Smoking weakens bone health and increases the risk of fractures. We investigated the incidence of fractures in smoking, fertile-aged women and compared it with that of non-smoking, fertile-aged women using data from nationwide registers. PATIENTS AND METHODS: We conducted a retrospective register-based nationwide cohort study from 1998 to 2018. We identified all women smoking during pregnancy from the Medical Birth Register and compared these with non-smokers. We gathered fractures for both groups from the Care Register for Health Care. Pregnancies with missing smoking or socioeconomic status were excluded. A Cox regression model was used to analyze adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for fractures during the 5-year follow-up starting from delivery. The model was adjusted for the age of the mother at the time of delivery and socioeconomic status. RESULTS: The smoking group included 110,675 pregnancies and the non-smoking group 628,085 pregnancies. The overall fracture rate was higher in smokers after 1-year follow-up (aHR 1.7, CI 1.5–2.0) and 5-year follow-up (aHR 1.7, CI 1.6–1.8). After 5-year follow-up, the fracture rates for polytraumas (aHR 2.3, CI 1.4–3.7), inpatient admitted fractures (aHR 2.0, CI 1.7–2.4), and non-admitted fractures (aHR 1.8, CI 1.7–1.9) were all higher among smoking women. CONCLUSION: Smoking in fertile-aged women was associated with a higher risk of fractures during the 1-year and 5-year follow-up after giving birth, also after adjusting for age and socioeconomic status. Whether the increased fracture risk is caused by direct effects of smoking on bone health or riskier behavior remains uncertain. Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation 2022-11-25 /pmc/articles/PMC9703666/ /pubmed/36440602 http://dx.doi.org/10.2340/17453674.2022.5275 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
spellingShingle Article
VAAJALA, Matias
KUITUNEN, Ilari
NYRHI, Lauri
PONKILAINEN, Ville
HUTTUNEN, Tuomas T
MATTILA, Ville M
Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title_full Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title_fullStr Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title_full_unstemmed Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title_short Smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in Finland
title_sort smoking is associated with an increased risk of fractures in women: a nationwide population-based cohort study in finland
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9703666/
https://www.ncbi.nlm.nih.gov/pubmed/36440602
http://dx.doi.org/10.2340/17453674.2022.5275
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