Do Canadian prenatal records support evidence-based practices to reduce maternal smoking?
OBJECTIVE
Maternal smoking remains the most important modifiable risk factor for adverse perinatal outcomes. Integrating evidence-based screening questions and intervention guides for maternal smoking into standardized prenatal records may improve the identification and treatment of pregnant smokers. This study sought to identify and compare how prenatal records across Canadian provinces and territories currently address the issue of maternal tobacco use.


METHODS
Content analysis of prenatal record forms from 11 provinces and territories was used to identify assessment questions and intervention prompts related to maternal smoking or exposure to environmental tobacco smoke. Findings were evaluated in light of current best-practice recommendations for maternal smoking cessation and prevention of relapse.


RESULTS
The content of prenatal records related to maternal smoking varies widely among Canadian provinces and territories. Most of the prenatal records surveyed lacked prompts to support key practices for the effective screening and treatment of maternal tobacco dependence, such as providing multiple response options to determine whether the pregnant woman or her partner smokes, monitoring maternal smoking patterns throughout the course of pregnancy, and referring pregnant smokers to specialized resources for smoking cessation.


CONCLUSIONS
Simple changes to Canadian prenatal record forms may lead to improved population-wide screening and counselling of pregnant smokers.
Semenic
Sonia
S
School of Nursing, University of Ottawa, Ottawa ON.
Edwards
Nancy
N
D000328:Adult; D002170:Canada / Q000453:epidemiology; D003376:Counseling; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention