Association of Smoking, Drinking by Couples and Their Interaction With Pre‐Eclampsia: A Prospective Cohort Study in Central China

Aim Previous studies reported inconsistent results on the effects of maternal smoking and drinking on pre‐eclampsia (PE). Furthermore, some studies indicated that the development of PE may also be attributable to unhealthy behaviors from men. Hence, this study aimed to evaluate the association between smoking and drinking by couples and PE in the Asian population. Methods A prospective cohort study including 34 104 couples was conducted. Multivariate logistic regression models were used to estimate the odds ratios (ORs) of couples' smoking and drinking behaviors and their interaction. The assignment score method was used to explore the cumulative effect of adverse behavioral exposures to alcohol and tobacco on PE. Results Seven hundred eighty‐eight‐pregnant women (2.31%) were diagnosed with PE. Maternal active smoking 3 months before pregnancy (OR: 2.010, 95% CI: 1.136–3.555), periconceptional active smoking (OR: 1.560, 95% CI: 1.027–2.368), drinking 3 months before pregnancy (OR: 2.101, 95% CI: 1.397–3.158), and periconceptional drinking (OR: 1.829, 95% CI: 1.318–2.539) were positively associated with PE. Spousal smoking was also a risk factor (OR: 1.174, 95% CI: 1.009–1.366). Additionally, there was an antagonistic effect between maternal active smoking and drinking during the periconceptional period. Moreover, with the increase of bad behaviors of couples, the risk of PE also increased to a certain extent. Conclusions Maternal active smoking and drinking as well as spousal smoking were risk enhancers of PE in the Asian population. We encourage both couples to actively quit smoking and drinking from the beginning of pregnancy preparation.