Patterns of tobacco exposure before and during pregnancy.
OBJECTIVE
To describe maternal exposure to tobacco in the three months before conception and throughout pregnancy, examine risk factors associated with tobacco exposure in pregnancy and smoking cessation, assess use of pharmacotherapy for smoking cessation and evaluate birth outcomes by smoking status.


METHODS
A cohort of women from a multi-site United States study were asked retrospectively about their exposure to tobacco.


METHODS
The study population was comprised of 4,667 mothers of non-malformed control infants who participated in the National Birth Defects Prevention Study from 1997 to 2003.


METHODS
Using computer-assisted telephone interview responses from this population-based sample, we assessed patterns of maternal smoking and exposure to environmental tobacco smoke (ETS) as well as use of pharmacotherapy for quitting smoking during pregnancy.


RESULTS
Overall, 961 (20.6%) mothers reported any smoking and 1,401 (30.0%) reported any exposure to ETS at home or work during the three months before conception through pregnancy. Of the 961 smokers, 512 (53.3%) reportedly quit smoking before or during pregnancy, including 379 (74% of quitters) in the first trimester, and 420 (43.7%) continued to smoke throughout the pregnancy. Only 2.1% of smokers reportedly used pharmacotherapy to quit smoking anytime from three months before conception through pregnancy. Low birthweight and preterm delivery rates were lowest among offspring of non-smokers and highest in offspring of those who continued to smoke throughout pregnancy.


CONCLUSIONS
About one-half of mothers who reported preconceptional smoking quit before or during pregnancy. Use of pharmacotherapy to quit smoking during pregnancy was not common.
Anderka
Marlene
M
Massachusetts Department of Public Health, Massachusetts Center for Birth Defects Research and Prevention, Boston, MA, USA.
Romitti
Paul A
PA
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
Sun
Lixian
L
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
Druschel
Charlotte
C
New York State Department of Health, Congenital Malformations Registry, Albany, NY, USA.
Carmichael
Suzan
S
March of Dimes Foundation, California Research Division, Oakland, California, USA.
Shaw
Gary
G
Department of Pediatrics, Stanford University, Stanford, California, USA.
D000328:Adult; D016642:Bupropion / Q000627:therapeutic use; D015331:Cohort Studies; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D005306:Fertilization; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D047928:Premature Birth / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
D018765:Dopamine Uptake Inhibitors; D014028:Tobacco Smoke Pollution; D016642:Bupropion