Effect of narghile and cigarette smoking on newborn birthweight

Objective  To assess the effect of narghile smoking on the weight of newborns. Design  Historical retrospective cohort. Setting  Six major hospitals in Greater Beirut, Lebanon. Population  Consecutive singleton newborns delivered from August 2000 to August 2003. Methods  Obstetric and nursery charts were reviewed to obtain information about maternal and neonatal variables. Information concerning initiation of smoking, dose of smoking, smoking habits during pregnancy, and socio-demographic characteristics was collected through interviews with mothers. Main outcome measures  Low birthweight and newborn birthweight. Results  Exclusive narghile smokers constituted 4.4% (378/8592) of women. Multiparas were significantly more likely to smoke cigarettes and narghile. Mothers smoking narghile more than once per day were at 2.4 increased odds of having low birthweight infants compared with nonsmoking mothers (OR 2.4; 95% CI 1.2–5.0) after adjusting for confounding variables. No difference was noted between women smoking narghile in the first trimester and those initiating smoking in subsequent trimesters regarding low birthweight. Conclusions  Narghile smoking more than once per day increases the odds of low birthweight by a 2.4-fold compared with nonsmokers, although to a lesser extent than cigarette smoking.