Table 6.

Impact of smokeless tobacco on stillbirths and perinatal mortality

Source	Location, Type of Study	Intervention	Stillbirths/Perinatal Outcomes
Observational studies
Gupta and Subramoney 2006 [47]	India. Population-based. Cohort study. N = 1110 pregnant women.	Compared the impact on stillbirths of women using smokeless tobacco (exposed) vs. non-users (unexposed).	SBR: adj. HR = 2.6 (95% CI: 1.4 – 4.8). [18/202 (8.9%) vs. 28/908 (3.1%) among exposed and unexposed groups, respectively].
Krishna 1978 [48]	India (Pune). Hospital-based. Cross-sectional study. N = 1388 singleton births.	Analyzed the impact on stillbirths of pregnant women who were tobacco chewers vs. non-users.	SBR: 3 times higher risk among tobacco users vs. controls.
Shah et al. 2000 [49]	India. Multicentre, hospital-based. Case-control study.	Compared the impact on perinatal mortality of women using tobacco vs. non-users.	PMR: 1.5 times higher risk (95% CI: 1.3 – 1.7).