Association of Cigarette Smoking Exposure in Pregnant patients and Uterine Atony

Background: Uterine atony, is one of the life-threatening emergency obstetrics complications that may be affected by vitamin D deficiency and cigarette smoking. Objective: To study the cause effect relationship between cigarette smoking and postpartum hemorrhage due to uterine atony. Methodology: A case-control study was conducted in District Headquarters Hospital, DG Khan, from March to August 2020, from the record room of the Obstetrics ward. A total of 236 patients were included in the study, where 56 were cases of uterine atony and 180 were controls who did not have uterine atony. History of exposure to cigarette smoking (active or passive smoking) was taken from the study subjects. All of the study subjects had a deficiency of serum vitamin D. Odds Ratio was calculated to determine an association between smoking and Uterine atony. Exclusion criteria; grand multipara, polyhydramnios, preeclampsia, chronic renal or liver diseases, bleeding disorders, retained products of conception, and patients having bleeding from cervix or vaginal tear. A p-value of less than 0.05 was taken as significant. Results: A total of 236 study subjects were included in the study. Out of 56 patients with uterine atony, 20 (35.7%) have a history of smoking, as compared to 120 (66.6%) out of 180 study subjects in controls. The odds Ratio was 0.27 which reflects that those who smoked (active or passive) during pregnancy have less chances of uterine atony and has a protective effect. (p=0.000) Conclusion: It was concluded that smoking was inversely associated with uterine atony and has a protective effect.