Determining effects of areca (betel) nut chewing in a prospective cohort of pregnant women in Madang Province, Papua New Guinea
Chewing areca nut (AN), also known as betel nut, is common in Asia and the South Pacific and the habit has been linked to a number of serious health problems including oral cancer. Use of AN in pregnancy has been associated with a reduction in mean birthweight in some studies, but this association a...
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| creator | Ome-Kaius, Maria Unger, Holger W Singirok, Dupain Wangnapi, Regina A Hanieh, Sarah Umbers, Alexandra J Elizah, Julie Siba, Peter Mueller, Ivo Rogerson, Stephen J |
| description | Chewing areca nut (AN), also known as betel nut, is common in Asia and the South Pacific and the habit has been linked to a number of serious health problems including oral cancer. Use of AN in pregnancy has been associated with a reduction in mean birthweight in some studies, but this association and the relationship between AN chewing and other adverse pregnancy outcomes remain poorly understood.
We assessed the impact of AN chewing on adverse outcomes including stillbirth, low birthweight (LBW, |
| doi_str_mv | 10.1186/s12884-015-0615-z |
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We assessed the impact of AN chewing on adverse outcomes including stillbirth, low birthweight (LBW, <2,500 g) and anaemia at delivery (haemoglobin <11.0 g/dL) in a longitudinal cohort of 2,700 pregnant women residing in rural lowland Papua New Guinea (PNG) from November 2009 until February 2013. Chewing habits and participant characteristics were evaluated at first antenatal visit and women were followed until delivery.
83.3% [2249/2700] of pregnant women used AN, and most chewed on a daily basis (86.2% [1939/2249]. Smoking and alcohol use was reported by 18.9% (511/2700) and 5.0% (135/2688) of women, respectively. AN use was not associated with pregnancy loss or congenital abnormalities amongst women with a known pregnancy outcome (n = 2215). Analysis of 1769 birthweights did not demonstrate an association between AN and LBW (chewers: 13.7% [200/1459] vs. non-chewers: 14.5% [45/310], P = 0.87) or reduced mean birthweight (2957 g vs. 2966 g; P = 0.76). Women using AN were more likely to be anaemic (haemoglobin <11 g/dL) at delivery (75.2% [998/1314] vs. 63.9% [182/285], adjusted odds ratio [95% CI]: 1.67 [1.27, 2.20], P < 0.001). Chewers more commonly had male babies than non-chewers (46.1% [670/1455] vs. 39.8% [123/309], P = 0.045).
AN chewing may contribute to anaemia. Although not associated with other adverse pregnancy outcome in this cohort gestational AN use should be discouraged, given the potential adverse effects on haemoglobin and well-established long-term health risk including oral cancer. Future research evaluating the potential association of AN use and anaemia may be warranted.
ClinicalTrials.gov NCT01136850 (06 April 2010).</description><identifier>ISSN: 1471-2393</identifier><identifier>EISSN: 1471-2393</identifier><identifier>DOI: 10.1186/s12884-015-0615-z</identifier><identifier>PMID: 26286026</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Alcohol Drinking - epidemiology ; Analysis ; Anemia ; Anemia - epidemiology ; Areca ; Assaigs clínics ; Cancer ; Clinical trials ; Cohort Studies ; Complicacions en l'embaràs ; Complications of pregnancy ; Drogues ; Drugs of abuse ; Female ; Genetic aspects ; Health aspects ; Health risk assessment ; Hemoglobin ; Humans ; Hypertension ; Infant, Low Birth Weight ; Infant, Newborn ; Longitudinal Studies ; Malaria ; Male ; Miscarriage ; Oncology, Experimental ; Oral cancer ; Papua New Guinea - epidemiology ; Pregnancy ; Pregnancy Complications - epidemiology ; Pregnancy Complications, Hematologic - epidemiology ; Pregnant women ; Prevalence ; Prospective Studies ; Public health ; Risk factors ; Rural Population ; Smoking - epidemiology ; Stillbirth ; Stillbirth - epidemiology ; Systematic review ; Tobacco ; Womens health ; Young Adult</subject><ispartof>BMC Pregnancy and Childbirth, 2015-08, Vol.15 (1), p.177-177, Article 177</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>2015. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>cc by (c) Ome-Kaius et al., 2015 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by/3.0/es/">http://creativecommons.org/licenses/by/3.0/es/</a></rights><rights>Ome-Kaius et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-76f7778c39c1e89f3037032ea4d867fffed379baf10825ac9115c62f7595c48c3</citedby><cites>FETCH-LOGICAL-c536t-76f7778c39c1e89f3037032ea4d867fffed379baf10825ac9115c62f7595c48c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543471/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543471/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,26973,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26286026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ome-Kaius, Maria</creatorcontrib><creatorcontrib>Unger, Holger W</creatorcontrib><creatorcontrib>Singirok, Dupain</creatorcontrib><creatorcontrib>Wangnapi, Regina A</creatorcontrib><creatorcontrib>Hanieh, Sarah</creatorcontrib><creatorcontrib>Umbers, Alexandra J</creatorcontrib><creatorcontrib>Elizah, Julie</creatorcontrib><creatorcontrib>Siba, Peter</creatorcontrib><creatorcontrib>Mueller, Ivo</creatorcontrib><creatorcontrib>Rogerson, Stephen J</creatorcontrib><title>Determining effects of areca (betel) nut chewing in a prospective cohort of pregnant women in Madang Province, Papua New Guinea</title><title>BMC Pregnancy and Childbirth</title><addtitle>BMC Pregnancy Childbirth</addtitle><description>Chewing areca nut (AN), also known as betel nut, is common in Asia and the South Pacific and the habit has been linked to a number of serious health problems including oral cancer. Use of AN in pregnancy has been associated with a reduction in mean birthweight in some studies, but this association and the relationship between AN chewing and other adverse pregnancy outcomes remain poorly understood.
We assessed the impact of AN chewing on adverse outcomes including stillbirth, low birthweight (LBW, <2,500 g) and anaemia at delivery (haemoglobin <11.0 g/dL) in a longitudinal cohort of 2,700 pregnant women residing in rural lowland Papua New Guinea (PNG) from November 2009 until February 2013. Chewing habits and participant characteristics were evaluated at first antenatal visit and women were followed until delivery.
83.3% [2249/2700] of pregnant women used AN, and most chewed on a daily basis (86.2% [1939/2249]. Smoking and alcohol use was reported by 18.9% (511/2700) and 5.0% (135/2688) of women, respectively. AN use was not associated with pregnancy loss or congenital abnormalities amongst women with a known pregnancy outcome (n = 2215). Analysis of 1769 birthweights did not demonstrate an association between AN and LBW (chewers: 13.7% [200/1459] vs. non-chewers: 14.5% [45/310], P = 0.87) or reduced mean birthweight (2957 g vs. 2966 g; P = 0.76). Women using AN were more likely to be anaemic (haemoglobin <11 g/dL) at delivery (75.2% [998/1314] vs. 63.9% [182/285], adjusted odds ratio [95% CI]: 1.67 [1.27, 2.20], P < 0.001). Chewers more commonly had male babies than non-chewers (46.1% [670/1455] vs. 39.8% [123/309], P = 0.045).
AN chewing may contribute to anaemia. Although not associated with other adverse pregnancy outcome in this cohort gestational AN use should be discouraged, given the potential adverse effects on haemoglobin and well-established long-term health risk including oral cancer. Future research evaluating the potential association of AN use and anaemia may be warranted.
ClinicalTrials.gov NCT01136850 (06 April 2010).</description><subject>Adult</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Analysis</subject><subject>Anemia</subject><subject>Anemia - epidemiology</subject><subject>Areca</subject><subject>Assaigs clínics</subject><subject>Cancer</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Complicacions en l'embaràs</subject><subject>Complications of pregnancy</subject><subject>Drogues</subject><subject>Drugs of abuse</subject><subject>Female</subject><subject>Genetic aspects</subject><subject>Health aspects</subject><subject>Health risk assessment</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Longitudinal Studies</subject><subject>Malaria</subject><subject>Male</subject><subject>Miscarriage</subject><subject>Oncology, Experimental</subject><subject>Oral cancer</subject><subject>Papua New Guinea - epidemiology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Complications, Hematologic - epidemiology</subject><subject>Pregnant women</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Risk factors</subject><subject>Rural Population</subject><subject>Smoking - epidemiology</subject><subject>Stillbirth</subject><subject>Stillbirth - epidemiology</subject><subject>Systematic review</subject><subject>Tobacco</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1471-2393</issn><issn>1471-2393</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>XX2</sourceid><recordid>eNpdUstu1DAUjRCIPuAD2CBLbFqJFD_iONkgVQUKUoEuYG15PNczrhI72MmM6IZf54YpowFZft5zrq-PT1G8YPSCsaZ-kxlvmqqkTJa0xuH-UXHMKsVKLlrx-GB9VJzkfEcpU42kT4sjXvOmprw-Ln69gxFS74MPKwLOgR0ziY6YBNaQswVGu3MSppHYNWxnkA_EkCHFPCDWb4DYuI5pnElDglUwYSTb2EOYkZ_N0iDnNsWNDxZek1szTIZ8gS25nnwA86x44kyX4fnDfFp8__D-29XH8ubr9aery5vSSlGPpaqdUqqxorUMmtYJKhQVHEy1bGrlsO6lUO3COEYbLo1tGZO25k7JVtoKeafF213eYVr0sLQQxmQ6PSTfm_RTR-P1v5Hg13oVN7qSlUAZMQHbJbB5shrVgWTN-Ie438ydU8U1lw3lEjlnD5em-GOCPOreZwtdZwLEKWumqFSCSy4Q-uo_6F2cUkBJNOe0Vfh1tULUxQ61Mh1oH1zEWi22JfTexgDO4_mlrFhFOdZ9UDV-WE7g9i9mVM8e0jsPafSQnj2k75Hz8lCqPeOvacRvXM3Cdg</recordid><startdate>20150819</startdate><enddate>20150819</enddate><creator>Ome-Kaius, Maria</creator><creator>Unger, Holger W</creator><creator>Singirok, Dupain</creator><creator>Wangnapi, Regina A</creator><creator>Hanieh, Sarah</creator><creator>Umbers, Alexandra J</creator><creator>Elizah, Julie</creator><creator>Siba, Peter</creator><creator>Mueller, Ivo</creator><creator>Rogerson, Stephen J</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>XX2</scope><scope>5PM</scope></search><sort><creationdate>20150819</creationdate><title>Determining effects of areca (betel) nut chewing in a prospective cohort of pregnant women in Madang Province, Papua New Guinea</title><author>Ome-Kaius, Maria ; Unger, Holger W ; Singirok, Dupain ; Wangnapi, Regina A ; Hanieh, Sarah ; Umbers, Alexandra J ; Elizah, Julie ; Siba, Peter ; Mueller, Ivo ; Rogerson, Stephen J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-76f7778c39c1e89f3037032ea4d867fffed379baf10825ac9115c62f7595c48c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Alcohol Drinking - epidemiology</topic><topic>Analysis</topic><topic>Anemia</topic><topic>Anemia - epidemiology</topic><topic>Areca</topic><topic>Assaigs clínics</topic><topic>Cancer</topic><topic>Clinical trials</topic><topic>Cohort Studies</topic><topic>Complicacions en l'embaràs</topic><topic>Complications of pregnancy</topic><topic>Drogues</topic><topic>Drugs of abuse</topic><topic>Female</topic><topic>Genetic aspects</topic><topic>Health aspects</topic><topic>Health risk assessment</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Longitudinal Studies</topic><topic>Malaria</topic><topic>Male</topic><topic>Miscarriage</topic><topic>Oncology, Experimental</topic><topic>Oral cancer</topic><topic>Papua New Guinea - epidemiology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Complications, Hematologic - epidemiology</topic><topic>Pregnant women</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Public health</topic><topic>Risk factors</topic><topic>Rural Population</topic><topic>Smoking - epidemiology</topic><topic>Stillbirth</topic><topic>Stillbirth - epidemiology</topic><topic>Systematic review</topic><topic>Tobacco</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ome-Kaius, Maria</creatorcontrib><creatorcontrib>Unger, Holger W</creatorcontrib><creatorcontrib>Singirok, Dupain</creatorcontrib><creatorcontrib>Wangnapi, Regina A</creatorcontrib><creatorcontrib>Hanieh, Sarah</creatorcontrib><creatorcontrib>Umbers, Alexandra J</creatorcontrib><creatorcontrib>Elizah, Julie</creatorcontrib><creatorcontrib>Siba, Peter</creatorcontrib><creatorcontrib>Mueller, Ivo</creatorcontrib><creatorcontrib>Rogerson, Stephen J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>Recercat</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC Pregnancy and Childbirth</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ome-Kaius, Maria</au><au>Unger, Holger W</au><au>Singirok, Dupain</au><au>Wangnapi, Regina A</au><au>Hanieh, Sarah</au><au>Umbers, Alexandra J</au><au>Elizah, Julie</au><au>Siba, Peter</au><au>Mueller, Ivo</au><au>Rogerson, Stephen J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Determining effects of areca (betel) nut chewing in a prospective cohort of pregnant women in Madang Province, Papua New Guinea</atitle><jtitle>BMC Pregnancy and Childbirth</jtitle><addtitle>BMC Pregnancy Childbirth</addtitle><date>2015-08-19</date><risdate>2015</risdate><volume>15</volume><issue>1</issue><spage>177</spage><epage>177</epage><pages>177-177</pages><artnum>177</artnum><issn>1471-2393</issn><eissn>1471-2393</eissn><abstract>Chewing areca nut (AN), also known as betel nut, is common in Asia and the South Pacific and the habit has been linked to a number of serious health problems including oral cancer. Use of AN in pregnancy has been associated with a reduction in mean birthweight in some studies, but this association and the relationship between AN chewing and other adverse pregnancy outcomes remain poorly understood.
We assessed the impact of AN chewing on adverse outcomes including stillbirth, low birthweight (LBW, <2,500 g) and anaemia at delivery (haemoglobin <11.0 g/dL) in a longitudinal cohort of 2,700 pregnant women residing in rural lowland Papua New Guinea (PNG) from November 2009 until February 2013. Chewing habits and participant characteristics were evaluated at first antenatal visit and women were followed until delivery.
83.3% [2249/2700] of pregnant women used AN, and most chewed on a daily basis (86.2% [1939/2249]. Smoking and alcohol use was reported by 18.9% (511/2700) and 5.0% (135/2688) of women, respectively. AN use was not associated with pregnancy loss or congenital abnormalities amongst women with a known pregnancy outcome (n = 2215). Analysis of 1769 birthweights did not demonstrate an association between AN and LBW (chewers: 13.7% [200/1459] vs. non-chewers: 14.5% [45/310], P = 0.87) or reduced mean birthweight (2957 g vs. 2966 g; P = 0.76). Women using AN were more likely to be anaemic (haemoglobin <11 g/dL) at delivery (75.2% [998/1314] vs. 63.9% [182/285], adjusted odds ratio [95% CI]: 1.67 [1.27, 2.20], P < 0.001). Chewers more commonly had male babies than non-chewers (46.1% [670/1455] vs. 39.8% [123/309], P = 0.045).
AN chewing may contribute to anaemia. Although not associated with other adverse pregnancy outcome in this cohort gestational AN use should be discouraged, given the potential adverse effects on haemoglobin and well-established long-term health risk including oral cancer. Future research evaluating the potential association of AN use and anaemia may be warranted.
ClinicalTrials.gov NCT01136850 (06 April 2010).</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26286026</pmid><doi>10.1186/s12884-015-0615-z</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC Pregnancy and Childbirth, 2015-08, Vol.15 (1), p.177-177, Article 177 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Springer Nature OA Free Journals; Recercat; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adult Alcohol Drinking - epidemiology Analysis Anemia Anemia - epidemiology Areca Assaigs clínics Cancer Clinical trials Cohort Studies Complicacions en l'embaràs Complications of pregnancy Drogues Drugs of abuse Female Genetic aspects Health aspects Health risk assessment Hemoglobin Humans Hypertension Infant, Low Birth Weight Infant, Newborn Longitudinal Studies Malaria Male Miscarriage Oncology, Experimental Oral cancer Papua New Guinea - epidemiology Pregnancy Pregnancy Complications - epidemiology Pregnancy Complications, Hematologic - epidemiology Pregnant women Prevalence Prospective Studies Public health Risk factors Rural Population Smoking - epidemiology Stillbirth Stillbirth - epidemiology Systematic review Tobacco Womens health Young Adult |
| title | Determining effects of areca (betel) nut chewing in a prospective cohort of pregnant women in Madang Province, Papua New Guinea |
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