Abstract

Studies on prenatal smoking and its association with infant respiratory distress syndrome are sparse. In a study by Curet et al. w1x the investigators found that the incidence of respiratory distress syndrome (RDS) among infants of nonsmoking gravidas was higher than among neonates of smoking mothers. Similar results were documented by other authors w2x. However, all these studies were conducted on singletons, and to our knowledge, there are as yet no data on multiples. This study explores the relationship between maternal smoking during pregnancy and the incidence of respiratory distress syndrome (RDS) among triplets in the United States during a period (1995–1997) when the use of steroids and surfactant therapy has become an established practice among preterm births. The current epidemic of multiple births, most remarkable among triplet gestations, coupled with the fact that 90% of triplets are born preterm w3x motivated us to undertake this study. The data for this analysis were from the ‘matched multiple birth file’ assembled by the National Center for Health Statistics (NCHS) cov-

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