title: Psychosocial resources and persistent smoking in early pregnancy--a population study of women in their first pregnancy in Sweden.
abstract: OBJECTIVE
  To test the stress hypothesis by characterising women during their first pregnancy who continue to smoke in early pregnancy in comparison with women who quit smoking, with special reference to psychosocial factors like social network, social support, demands, and control in work and daily life.
  
  
  METHODS
  The study is based on a cohort of primigravidas followed during pregnancy. Data were collected by self administered questionnaires during the pregnant womens' first antenatal visit at about 12 weeks.
  
  
  METHODS
  The study was performed in the antenatal clinics in the city of Malmö, Sweden.
  
  
  METHODS
  The participants were all primigravidas living in the city of Malmö, Sweden, over a one year period, 1991-92. A total of 872 (87.7%) of the 994 invited women agreed to participate. The population of this study on smoking includes all primigravidas who at the time of conception were smoking (n = 404, 46.3%).
  
  
  RESULTS
  At the first antenatal visit (63.6% (n = 257) of the prepregnancy smokers were still smoking (a total smoking prevalence of 29.5%). The pregnant smokers were on average younger and had a lower educational level. The highest relative risk (RR) of continued smoking was found among unmarried women RR 2.7 (95% confidence interval) (1.5, 4.8), women having unplanned pregnancies RR 2.2 (1.2, 4.0) and those with a low social participation RR 1.6 (1.0, 2.7), low instrumental support RR 2.6 (1.2, 6.0), low support from the child's father RR 2.1 (1.0, 4.2) and those exposed to job strain RR = 2.3 (1.1, 4.8). The associations were independent of potential confounders such as age, educational level, nationality, cohabiting status, passive smoking, and previous years of smoking.
  
  
  CONCLUSIONS
  This study supports the stress hypothesis. Smoking can be one way women handle stress when demands become too great. In order to reduce smoking among pregnant women, maternity centre resources need to be focused more on women with low psychosocial resources who are at highest risk for continued smoking. It is also important to involve actively the woman's partner or other important people in the woman's social network.
authors: Department of Community Medicine, Lund University, Sweden.
authors: E
authors: E
authors: Dejin-Karlsson
authors: B S
authors: BS
authors: Hanson
authors: P O
authors: PO
authors: Ostergren
authors: J
authors: J
authors: Ranstam
authors: S O
authors: SO
authors: Isacsson
authors: N O
authors: NO
authors: Sjöberg
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011610:Psychosocial Deprivation; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology; D013548:Sweden / Q000453:epidemiology