Smoking during pregnancy: A population-based study

2016 ◽  
Vol 45 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Gudrun Nina Oskarsdottir ◽  
Hedinn Sigurdsson ◽  
Kristjan G. Gudmundsson
Keyword(s):  
Mental Health ◽  
Social Status ◽  
Early Pregnancy ◽  
Healthcare Setting ◽  
Population Based ◽  
Future Health ◽  
Health Care Centre ◽  
Smoking During Pregnancy ◽  
Smoking In Pregnancy ◽  
In Pregnancy

Aims: Tobacco is a major cause of disease and mortality in modern times. The risk of smoking in pregnancy is a serious threat to the development and future health of an unborn child. The aim of this study was to explore the epidemiological factors associated with smoking during pregnancy in a primary healthcare setting. Methods: All 856 maternity records at the Glaesibaer Health Care Centre in Reykjavik during 2006–2013 were reviewed and information on smoking habits investigated. Results: The records showed that in 108 (12.2%) pregnancies, women smoked at first visit and 63 stopped smoking in early pregnancy, leaving 45 (5.3%) mothers smoking throughout the whole gestational period. The mean age of the smoking women was 27.8 years and for the non-smokers 29.7 years. Low social status (odds ratio (OR) = 2.66; 95% confidence interval (CI): 1.19–5.96), previous mental health diagnosis (OR = 2.7; 95% CI: 1.3–5.6), and unstable relationship with a partner (OR = 3.78; 95% CI: 2.1–7.0) were associated with smoking. Smoking fewer cigarettes was associated with a 0.04-unit lower risk of smoking during pregnancy (OR = 0.04: 95% CI: 0.02–0.08). Conclusions: Our results indicated that the women who smoked during pregnancy were often heavy smokers and living without a partner. They were younger, had worse mental health, and a lower social status than those pregnant women who did not smoke. Bearing in mind the consequence of smoking in pregnancy, this subgroup should get increased assistance to quit smoking before and during early pregnancy, as well as appropriate medical and social support.

scholarly journals Acquisition and Elimination of Bacterial Vaginosis During Pregnancy: A Danish Population-Based Study

2006 ◽  
Vol 2006 ◽  
pp. 1-6 ◽  
Author(s):  
Ida Vogel ◽  
Poul Thorsen ◽  
Bernard Jeune ◽  
Bo Jacobsson ◽  
Niels Ebbesen ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Early Pregnancy ◽  
Elimination Rate ◽  
Population Based ◽  
Gradual Change ◽  
Third Trimester ◽  
Clinical Criteria ◽  
Vaginal Ph ◽  
Increased Risk ◽  
In Pregnancy

Objectives: the aim was to examine factors associated with acquisition and elimination of bacterial vaginosis in pregnancy.Methods: a group of 229 pregnant women were randomly selected from a population-based prospective cohort study of 2927. They were examined at enrollment (mean gestational weeks16w+0d) and again in mid-third trimester (mean gestational age32w+3d).Measures: BV (Amsel's clinical criteria), microbiological cultures of the genital tract and questionnaire data.Results: BV prevalence decreased from 17% in early second trimester to 14% in mid-third trimester due to a tenfold higher elimination rate (39%) than incidence rate (4%). Heavy smokers(>10/d)in early pregnancy were at increased risk(5.3 [1.1−25])for the acquisition of BV during pregnancy, as were women receiving public benefits(4.8 [1.0−22]), having a vaginal pH above4.5 (6.3 [1.4−29])or vaginal anaerobe bacteria(18 [2.7−122])at enrollment. A previous use of combined oral contraceptives was preventive for the acquisition of BV(0.2 [0.03−0.96]). Elimination of BV in pregnancy tended to be associated with a heavy growth ofLactobacillus (3.2 [0.8−13])at enrollment.Conclusions: acquisition of BV during pregnancy is rare and is associated with smoking, while the presence of anaerobe bacteria and a vaginal pH> 4.5are interpreted as steps on a gradual change towards BV. In the same way heavy growth ofLactobacillusspp in early pregnancy may be an indicator of women on the way to eliminate BV.

scholarly journals Ancestral smoking and developmental outcomes: A review of publications from a population birth cohort

2021 ◽  
Author(s):  
Jean Golding ◽  
Marcus Pembrey ◽  
Yasmin Iles-Caven ◽  
Sarah Watkins ◽  
Matthew Suderman ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Smoking During Pregnancy ◽  
Beneficial Effects ◽  
Smoking In Pregnancy ◽  
Parents And Children ◽  
Paternal Grandmother ◽  
Sex Specificity ◽  
Using Data ◽  
Offspring Health ◽  
In Pregnancy

Abstract The adverse effects on the child of maternal smoking in pregnancy is well-recognised, but little research has been carried out on the possible non-genetic effects of ancestral smoking prior to the pregnancy including parental initiation of cigarette smoking in their own childhoods or a grandmother smoking during pregnancy. Here we summarise the studies that have been published mainly using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We demonstrate evidence that ancestral smoking prior to or during pregnancy can often be beneficial for offspring health and both ancestor- and sex-specific. More specifically, we report evidence of (i) adverse effects of the father starting to smoke pre-puberty on his son’s development; (ii) beneficial effects on the grandson if his maternal grandmother had smoked in pregnancy; and (iii) mainly adverse effects on the granddaughter when the paternal grandmother had smoked in pregnancy. The ancestor- and sex-specificity of these results is consistent with earlier studies reporting associations of health and mortality with ancestral food supply in their parents’ and grandparents’ pre-pubertal childhoods.

scholarly journals The association of maternal-fetal attachment with smoking and smoking cessation during pregnancy in The FinnBrain Birth Cohort Study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heidi Jussila ◽  
Juho Pelto ◽  
Riikka Korja ◽  
Eeva Ekholm ◽  
Marjukka Pajulo ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cohort Study ◽  
Early Pregnancy ◽  
Smoking Behavior ◽  
Birth Cohort Study ◽  
Prenatal Smoking ◽  
Smoking In Pregnancy ◽  
Maternal Fetal Attachment ◽  
Fetal Attachment ◽  
In Pregnancy

Abstract Background Smoking in pregnancy constitutes a preventable risk factor for fetal/child development and maternal-fetal attachment (MFA) seems to contain a momentum that can break the chain of adverse outcomes by promoting maternal prenatal health practices. This study aimed to explore the association of MFA with smoking at any time during pregnancy and smoking cessation in early pregnancy, and the modifying role of MFA on the expected effects of education and prenatal psychological distress (PPD) on prenatal smoking behavior. Methods The pregnant women (n = 3766) participated in the The FinnBrain Birth Cohort Study in Finland between December 2011 and April 2015. The binary outcomes, smoking at any time during pregnancy and smoking cessation in early pregnancy, were obtained from self-reports at gestational weeks (gwks) 14 and 34 and The Finnish Medical Birth Register. MFA was assessed with the Maternal-Fetal Attachment Scale (MFAS) at gwks 24 and 34. Logistic regression analyses were used to determine the association between MFA and maternal prenatal smoking behavior. Findings The prevalence of smoking was 16.5%, and 58.1% of the smokers quit smoking during pregnancy. The independent associations of total MFA scores with prenatal smoking behavior were not established (aOR = 1.00-1.02, multiplicity adjusted p > 0.05). A higher score in the altruistic subscale of MFA, Giving of self, associated with a higher probability of smoking cessation (24 gwks: aOR = 1.13, 95% CI [1.04, 1.24], p = 0.007, multiplicity adjusted p = 0.062; 34 gwks: aOR = 1.17, 95% CI [1.07, 1.29], p < 0.001, multiplicity adjusted p = 0.008). The modifying effect of MFA on the observed associations between PPD and smoking in pregnancy and between maternal education and smoking in pregnancy / smoking cessation in early pregnancy was not demonstrated. Conclusions The altruistic dimension of maternal-fetal attachment associates with an increased probability of smoking cessation during pregnancy and therefore strengthening altruistic maternal-fetal attachment may constitute a promising novel approach for interventions aiming at promoting smoking cessation during pregnancy.

scholarly journals Maternal smoking during pregnancy and asthma during the first year of life: a comparative study between smokers and non-smoker mothers

2021 ◽  
Vol 49 (5) ◽  
pp. 32-41
Author(s):  
Cristina Rivas Juesas ◽  
Lucia Fernández Monge ◽  
Ana Delgado Vicente ◽  
Ana Ledo García ◽  
Maribel Giner Crespo ◽  
...  
Keyword(s):  
Maternal Smoking ◽  
First Year ◽  
Smoking During Pregnancy ◽  
Smoking In Pregnancy ◽  
Smoking Group ◽  
One Year ◽  
Care Problems ◽  
First Year Of Life ◽  
The Relationship ◽  
In Pregnancy

Background: We investigated the relationship between maternal smoking in pregnancy and health care problems in the offspring during the first year of life, particularly asthma.Material and Methods: A cohort of 648 consecutive infants born at term and alive at Hospitalde Sagunto (Valencia, Spain) over one year period was followed for 12 months. Clinical data of the infants were prospectively collected from the database of ambulatory medical records (ABUCASIS) of the Valencia health system.Results: Smoking during pregnancy was recorded in 164 (25.3%) mothers. During the first year of life, asthma was diagnosed in 101 infants, with an incidence of 15.7%. The diagnoses of asthma (25.6% vs. 12.3%; P < 0.0001) and bronchiolitis (44.5% vs. 28.6%; P = 0.0002) during the first year of life were more common among infants in the smoking group. The probability of developing asthma during the first year of life was two-fold higher for the male gender and 2.5 times higher when mothers smoked while pregnant. Up to 52% of asthma cases could have been avoided in infants born to smoking mothers if they did not smoke during pregnancy. Infants in the smoking group showed a lower weight and length at birth than infants in the nonsmoking group differences almost disappeared at 6 months and 12 months.Conclusion: Asthma during the first year of life showed a clear relationship with maternal smoking in pregnancy. Pregnant women should be advised of the significant perinatal risk for respiratory diseases associated with tobacco use.

scholarly journals Risks and benefits of psychotropic medication in pregnancy: cohort studies based on UK electronic primary care health records

2016 ◽  
Vol 20 (23) ◽  
pp. 1-176 ◽  
Author(s):  
Irene Petersen ◽  
Rachel L McCrea ◽  
Cormac J Sammon ◽  
David PJ Osborn ◽  
Stephen J Evans ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cohort Studies ◽  
Psychotropic Medication ◽  
Early Pregnancy ◽  
Congenital Malformations ◽  
Child Outcomes ◽  
Risks And Benefits ◽  
Major Congenital Malformations ◽  
In Pregnancy

BackgroundAlthough many women treated with psychotropic medication become pregnant, no psychotropic medication has been licensed for use in pregnancy. This leaves women and their health-care professionals in a treatment dilemma, as they need to balance the health of the woman with that of the unborn child. The aim of this project was to investigate the risks and benefits of psychotropic medication in women treated for psychosis who become pregnant.Objective(s)(1) To provide a descriptive account of psychotropic medication prescribed before pregnancy, during pregnancy and up to 15 months after delivery in UK primary care from 1995 to 2012; (2) to identify risk factors predictive of discontinuation and restarting of lithium (multiple manufacturers), anticonvulsant mood stabilisers and antipsychotic medication; (3) to examine the extent to which pregnancy is a determinant for discontinuation of psychotropic medication; (4) to examine prevalence of records suggestive of adverse mental health, deterioration or relapse 18 months before and during pregnancy, and up to 15 months after delivery; and (5) to estimate absolute and relative risks of adverse maternal and child outcomes of psychotropic treatment in pregnancy.DesignRetrospective cohort studies.SettingPrimary care.ParticipantsWomen treated for psychosis who became pregnant, and their children.InterventionsTreatment with antipsychotics, lithium or anticonvulsant mood stabilisers.Main outcome measuresDiscontinuation and restarting of treatment; worsening of mental health; acute pre-eclampsia/gestational hypertension; gestational diabetes; caesarean section; perinatal death; major congenital malformations; poor birth outcome (low birthweight, preterm birth, small for gestational age, low Apgar score); transient poor birth outcomes (tremor, agitation, breathing and muscle tone problems); and neurodevelopmental and behavioural disorders.Data sourcesClinical Practice Research Datalink database and The Health Improvement Network primary care database.ResultsPrescribing of psychotropic medication was relatively constant before pregnancy, decreased sharply in early pregnancy and peaked after delivery. Antipsychotic and anticonvulsant treatment increased over the study period. The recording of markers of worsening mental health peaked after delivery. Pregnancy was a strong determinant for discontinuation of psychotropic medication. However, between 40% and 76% of women who discontinued psychotropic medication before or in early pregnancy restarted treatment by 15 months after delivery. The risk of major congenital malformations, and neurodevelopmental and behavioural outcomes in valproate (multiple manufacturers) users was twice that in users of other anticonvulsants. The risks of adverse maternal and child outcomes in women who continued antipsychotic use in pregnancy were not greater than in those who discontinued treatment before pregnancy.LimitationsA few women would have received parts of their care outside primary care, which may not be captured in this analysis. Likewise, the analyses were based on prescribing data, which may differ from usage.ConclusionsPsychotropic medication is prescribed before, during and after pregnancy. Many women discontinue treatment before or during early pregnancy and then restart again in late pregnancy or after delivery. Our results support previous associations between valproate and adverse child outcomes but we found no evidence of such an association for antipsychotics.Future workFuture research should focus on (1) curtailing the use of sodium valproate; (2) estimating the benefits of psychotropic drug use in pregnancy; and (3) investigating the risks associated with lifestyle choices that are more prevalent among women using psychotropic drugs.Funding detailsThe National Institute for Health Research Health Technology Assessment programme.

Isolation, Marginalisation and Disempowerment – Understanding How Interactions with Health Providers Can Influence Smoking Cessation in Pregnancy

2021 ◽  
Author(s):  
Cherise Fletcher ◽  
Elizabeth Hoon ◽  
Angela Gialamas ◽  
Gustaaf Dekker ◽  
John Lynch ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Focus Groups ◽  
South Australia ◽  
Antenatal Clinic ◽  
Health Providers ◽  
Smoking During Pregnancy ◽  
Healthcare Barriers ◽  
Adverse Health Outcomes ◽  
Smoking In Pregnancy ◽  
In Pregnancy

Abstract BackgroundMaternal smoking during pregnancy can lead to serious adverse health outcomes for both women and their infants. While smoking in pregnancy has declined over time, it remains consistently higher in women with lower socioeconomic circumstances. Furthermore, fewer women in this group will successfully quit during pregnancy. AimThis study explores the barriers to smoking cessation experienced by socially disadvantaged pregnant women and investigates how interactions with health providers can influence their smoking cessation journey.Methodsomen (either pregnant or birthed in the previous 10 years, who smoked or quit smoking in pregnancy) were recruited from a metropolitan public hospital antenatal clinic in South Australia and community organisations in surrounding suburbs. Seventeen women participated in qualitative semi-structured small focus groups or interviews. The focus groups and interviews were recorded, transcribed and thematically analysed. FindingsFour interconnected themes were identified: 1) smoking embedded in women’s challenging lives and pregnancies, 2) cyclic isolation and marginalisation, 3) feeling disempowered, and 4) autonomy and self-determination. Themes 3 and 4 are characterised as being two sides of a single coin in that they coexist simultaneously and are inseparable. A key finding is a strong unanimous desire for smoking cessation in pregnancy but women felt they did not have the necessary support from health providers or confidence and self-efficacy to be successful.ConclusionWomen would like improvements to antenatal care that increase health practitioners’ understanding of the social and contextual healthcare barriers faced by women who smoke in pregnancy. They seek assistance from health providers to make informed choices about smoking cessation and would like women-centred care. Women feel that with greater support, consistency and encouragement from health providers they could be more successful at antenatal smoking cessation.

scholarly journals Timing- and Dose-Specific Associations of Prenatal Smoke Exposure With Newborn DNA Methylation

2020 ◽  
Vol 22 (10) ◽  
pp. 1917-1922
Author(s):  
Giulietta S Monasso ◽  
Vincent W V Jaddoe ◽  
Johan C de Jongste ◽  
Liesbeth Duijts ◽  
Janine F Felix
Keyword(s):  
Dna Methylation ◽  
Early Pregnancy ◽  
Maternal Smoking ◽  
Third Trimester ◽  
Smoking During Pregnancy ◽  
The Third ◽  
Quitting Smoking ◽  
Maternal Smoking During Pregnancy ◽  
Paternal Smoking ◽  
In Pregnancy

Abstract Introduction Fetal changes in DNA methylation may underlie associations of maternal smoking during pregnancy with adverse outcomes in children. We examined critical periods and doses of maternal smoking during pregnancy in relation to newborn DNA methylation, and associations of paternal smoking with newborn DNA methylation. Aims and Methods This study was embedded in the Generation R Study, a population-based prospective cohort study from early pregnancy onwards. We assessed parental smoking during pregnancy using questionnaires. We analyzed associations of prenatal smoke exposure with newborn DNA methylation at 5915 known maternal smoking-related cytosine-phosphate-guanine sites (CpGs) in 1261 newborns using linear regression. Associations with false discovery rate-corrected p-values &lt; .05 were taken forward. Results Sustained maternal smoking was associated with newborn DNA methylation at 1391 CpGs, compared with never smoking. Neither quitting smoking early in pregnancy nor former smoking was associated with DNA methylation, compared with never smoking. Among sustained smokers, smoking ≥5, compared with &lt;5, cigarettes/d was associated with DNA methylation at seven CpGs. Paternal smoking was not associated with DNA methylation, independent of maternal smoking status. Conclusions Our results suggest that CpGs associated with sustained maternal smoking are not associated with maternal smoking earlier in pregnancy or with paternal smoking. Some of these CpGs show dose–response relationships with sustained maternal smoking. The third trimester may comprise a critical period for associations of smoking with newborn DNA methylation, or sustained smoking may reflect higher cumulative doses. Alternatively, maternal smoking limited to early pregnancy and paternal smoking may be associated with DNA methylation at specific other CpGs not studied here. Implications Our results suggest that quitting maternal smoking before the third trimester of pregnancy, and possibly lowering smoking dose, may prevent differential DNA methylation in the newborns at CpGs associated with sustained smoking. If the relevance of DNA methylation for clinical outcomes is established, these results may help in counseling parents-to-be about quitting smoking.

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