Stage of change is associated with assessment of the health risks of maternal smoking among pregnant women

AbstractIntroductionDuring pregnancy, the imperative to stop smoking becomes urgent due to health risks for mother and baby.AimExplore responses to a smoking-related, pregnancy-focused Risk Behaviour Diagnosis (RBD) Scale over time with Aboriginal1 pregnant women.MethodsSix Aboriginal Medical Services in three states recruited 22 eligible women: ⩽28 weeks' gestation, ⩾16 years old, smoked tobacco, pregnant with an Aboriginal baby. Surveys were completed at baseline (n = 22), 4-weeks (n = 16) and 12-weeks (n = 17). RBD Scale outcome measures included: perceived threat (susceptibility and severity), perceived efficacy (response and self-efficacy), fear control (avoidance), danger control (intentions to quit) and protection responses (protecting babies).ResultsAt baseline, the total mean threat scores at 4.2 (95% CI: 3.9–4.4) were higher than total mean efficacy scores at 3.9 (95% CI: 3.6–4.1). Over time there was a non-significant reduction in total mean threat and efficacy; fear control increased; danger control and protection responses remained stable. Reduction of threat and efficacy perceptions, with raised fear control responses, may indicate a blunting effect (a coping style which involves avoidance of risks).ConclusionIn 22 Aboriginal pregnant women, risk perception changed over time. A larger study is warranted to understand how Aboriginal women perceive smoking risks as the pregnancy progresses so that health messages are delivered accordingly.

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Thyroglobulin in smoking mothers and their newborns at delivery suggests autoregulation of placental iodide transport overcoming thiocyanate inhibition

Acta Endocrinologica ◽

10.1530/eje-12-0759 ◽

2013 ◽

Vol 168 (5) ◽

pp. 723-731 ◽

Cited By ~ 18

Author(s):

Stine L Andersen ◽

Susanne B Nøhr ◽

Chun S Wu ◽

Jørn Olsen ◽

Klaus M Pedersen ◽

...

Keyword(s):

Pregnant Women ◽

Iodine Deficiency ◽

Maternal Smoking ◽

Maternal Serum ◽

Sodium Iodide Symporter ◽

Hormone Production ◽

Cord Serum ◽

Iodide Transport ◽

Lactating Mammary Gland ◽

The Impact

BackgroundPlacental transport of iodide is required for fetal thyroid hormone production. The sodium iodide symporter (NIS) mediates active iodide transport into the thyroid and the lactating mammary gland and is also present in placenta. NIS is competitively inhibited by thiocyanate from maternal smoking, but compensatory autoregulation of iodide transport differs between organs. The extent of autoregulation of placental iodide transport remains to be clarified.ObjectiveTo compare the impact of maternal smoking on thyroglobulin (Tg) levels in maternal serum at delivery and in cord serum as markers of maternal and fetal iodine deficiency.MethodsOne hundred and forty healthy, pregnant women admitted for delivery and their newborns were studied before the iodine fortification of salt in Denmark. Cotinine in urine and serum classified mothers as smokers (n=50) or nonsmokers (n=90). The pregnant women reported on intake of iodine-containing supplements during pregnancy and Tg in maternal serum at delivery and in cord serum were analyzed.ResultsIn a context of mild-to-moderate iodine deficiency, smoking mothers had significantly higher serum Tg than nonsmoking mothers (mean Tg smokers 40.2 vs nonsmokers 24.4 μg/l, P=0.004) and so had their respective newborns (cord Tg 80.2 vs 52.4 μg/l, P=0.006), but the ratio between Tg in cord serum and maternal serum was not significantly different in smokers compared with nonsmokers (smoking 2.06 vs nonsmoking 2.22, P=0.69).ConclusionMaternal smoking increased the degree of iodine deficiency in parallel in the mother and the fetus, as reflected by increased Tg levels. However, placental iodide transport seemed unaffected despite high thiocyanate levels, suggesting that thiocyanate-insensitive iodide transporters alternative to NIS are active or that NIS in the placenta is autoregulated to keep iodide transport unaltered.

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Pregnant women warned of potential health risks from contact with sheep

Nursing Standard ◽

10.7748/ns.23.24.10.s15 ◽

2009 ◽

Vol 23 (24) ◽

pp. 10-10

Keyword(s):

Pregnant Women ◽

Health Risks ◽

Potential Health

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PMM.58 Who should support pregnant women to quit smoking? Early findings from a quasi-experiment building upon NICE guidance: Models for Access to Maternal Smoking cessation Support (MAMSS)

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2014-306576.413 ◽

2014 ◽

Vol 99 (Suppl 1) ◽

pp. A142.1-A142

Author(s):

A Grant ◽

R Lewis ◽

S Jones ◽

S Paranjothy

Keyword(s):

Smoking Cessation ◽

Pregnant Women ◽

Maternal Smoking ◽

Quit Smoking ◽

Nice Guidance ◽

Quasi Experiment

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Using Health Information Technology to Engage African American Women on Nutrition and Supplement Use During the Preconception Period

Frontiers in Endocrinology ◽

10.3389/fendo.2020.571705 ◽

2021 ◽

Vol 11 ◽

Author(s):

Paula Gardiner ◽

Timothy Bickmore ◽

Leanne Yinusa-Nyahkoon ◽

Matthew Reichert ◽

Clevanne Julce ◽

...

Keyword(s):

African American ◽

African American Women ◽

Health Risks ◽

Preconception Care ◽

Clinical Care ◽

Stage Of Change ◽

Control Group ◽

Conversational Agent ◽

Supplement Use ◽

The Impact

ImportanceHealthy nutrition and appropriate supplementation during preconception have important implications for the health of the mother and newborn. The best way to deliver preconception care to address health risks related to nutrition is unknown.MethodsWe conducted a secondary analysis of data from a randomized controlled trial designed to study the impact of conversational agent technology in 13 domains of preconception care among 528 non-pregnant African American and Black women. This analysis is restricted to those 480 women who reported at least one of the ten risks related to nutrition and dietary supplement use.InterventionsAn online conversational agent, called “Gabby”, assesses health risks and delivers 12 months of tailored dialogue for over 100 preconception health risks, including ten nutrition and supplement risks, using behavioral change techniques like shared decision making and motivational interviewing. The control group received a letter listing their preconception risks and encouraging them to talk to a health care provider.ResultsAfter 6 months, women using Gabby (a) reported progressing forward on the stage of change scale for, on average, 52.9% (SD, 35.1%) of nutrition and supplement risks compared to 42.9% (SD, 35.4) in the control group (IRR 1.22, 95% CI 1.03–1.45, P = 0.019); and (b) reported achieving the action and maintenance stage of change for, on average, 52.8% (SD 37.1) of the nutrition and supplement risks compared to 42.8% (SD, 37.9) in the control group (IRR 1.26, 96% CI 1.08–1.48, P = 0.004). For subjects beginning the study at the contemplation stage of change, intervention subjects reported progressing forward on the stage of change scale for 75.0% (SD, 36.3%) of their health risks compared to 52.1% (SD, 47.1%) in the control group (P = 0.006).ConclusionThe scalability of Gabby has the potential to improve women’s nutritional health as an adjunct to clinical care or at the population health level. Further studies are needed to determine if improving nutrition and supplement risks can impact clinical outcomes including optimization of weight.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT01827215.

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Awareness of Pregnancy-Associated Health Risks Among Pregnant Women and Male Partners Surveyed in a Prenatal Clinic

Journal of Women s Health ◽

10.1089/jwh.2018.7585 ◽

2020 ◽

Vol 29 (3) ◽

pp. 376-382

Author(s):

Michelle Mellon ◽

Andrew Schiller ◽

Anita L. Nelson ◽

Hindi E. Stohl

Keyword(s):

Pregnant Women ◽

Health Risks ◽

Male Partners

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Poor Understanding of Pregnancy-Associated Health Risks Among Indigent Pregnant Women [23N]

Obstetrics and Gynecology ◽

10.1097/01.aog.0000533119.33924.c1 ◽

2018 ◽

Vol 131 ◽

pp. 158S ◽

Cited By ~ 1

Author(s):

Michelle Mellon ◽

Andrew Schiller ◽

Anita L. Nelson ◽

Hindi E. Stohl ◽

Fanglong Dong

Keyword(s):

Pregnant Women ◽

Health Risks ◽

Poor Understanding

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FACTORS AFFECTING BIRTH WEIGHT

PEDIATRICS ◽

10.1542/peds.84.3.a90 ◽

1989 ◽

Vol 84 (3) ◽

pp. A90-A90

Author(s):

Student

Keyword(s):

Birth Weight ◽

Pregnant Women ◽

Fetal Growth ◽

Research Group ◽

Maternal Smoking ◽

Low Birthweight ◽

District General Hospital ◽

Maternal Height ◽

Socioeconomic Conditions ◽

Factors Affecting

Maternal smoking, stress, and poor socioeconomic conditions during pregnancy have been linked with low birthweight babies. Is there any way of deciding which of these related potential causes is the most important? In an attempt to do that a research group. . . studied over 1500 pregnant women delivering at a district general hospital in inner London. They showed that the most important influence on fetal growth was smoking, which was associated with a 5% reduction in birth weight after adjustment for maternal height and parity, gestation, and the baby's sex. Of over 40 socioeconomic and psychosocial factors examined, only four were significantly related to a reduction in birth weight, and these became non-significant after adjustment for smoking. The authors conclude that any effects of stress and poor environment on fetal growth are small compared with the effect of smoking.

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