Health-Related Quality of Life Among Pregnant Women with Pre-pregnancy Smoking in China: A National Cross-sectional Study (Preprint)

BACKGROUND Previous researches didn’t explore the influence of smoking before pregnancy on the health-related quality of life (HRQoL)of Chinese pregnant women, which is a big population in the largest developing country in the world and cannot be neglected. OBJECTIVE To evaluate the HRQoL of pregnant women in China with different smoking status and further to estimate the association between pre-pregnancy smoking and HRQoL. METHODS A nationwide-based cross-sectional study was conducted to determine the association between different smoking status (smoking currently, quit smoking, never smoking) and HRQoL in pregnant women across China. A web-based questionnaire was administered during prenatal examinations. EuroQoL Group’s five-dimension (EQ-5D-5L) scale with EuroQoL Group’s visual analog scale (EQ-5D VAS) scale were used for measuring HRQoL. RESULTS A total of 16,811 participants were included in the study. Significant difference in EQ-5D VAS was detected between non-smokers and ex-smokers (P<.001). Among ex-smokers, the proportion of pregnant women who suffer from depression/anxiety is higher compared with non-smokers (P<.001). We found that the increased cigarette consumption before pregnancy could result in lower EQ-5D VAS (P=.04) and EQ-5D index (P=.005) of pregnant women in China. CONCLUSIONS Chinese pregnant women with smoking history tend to have lower HRQoL. Smoking cessation during pregnancy doesn’t not significantly improve the HRQoL of Chinese pregnant women compared to smokers. Compared to non-smokers, ex-smokers are more likely to suffer from depression/anxiety. Among ex-smokers, the more cigarettes the Chinese pregnant women smoked, the lower their HRQoL. We suggest that the Chinese government should strengthen the education of stopping smoking and avoiding second-hand smoke for women who have pregnancy plan and their family members.