Disparate rates of persistent smoking and drug use during pregnancy of women of Hawaiian ancestry.
BACKGROUND
Significant disparity in smoking rates has been previously reported in pregnant and non-pregnant women of Native Hawaiian ancestry. Disparities in drug use rates have also been reported in non-pregnant women of Native Hawaiian ancestry.


OBJECTIVE
We undertook this study to compare rates of smoking and drug use during pregnancy among women in Hawaii to see if these differences are associated with disparities in pregnancy complications among Native Hawaiian women.


METHODS
Women were enrolled in the Pacific Research Center on Early Human Development study from July 2007 to January 2008, according to approved protocols. Persistent smoking was defined as self-reported smoking within 1 week of admission for labor. Drug use data was assessed by self-report, or if available, toxicology tests at the time of labor.


RESULTS
There were 868 women enrolled in the study during this period. Women of Hawaiian/part-Hawaiian ancestry comprised 22% of the study population. Rates of persistent smoking and drug use among Hawaiian women were significantly higher than the remainder of the study population (21% and 8.3% vs. 7.8% and 2.1%, respectively, P < .001 for both). Methamphetamine use was associated with an almost 5-fold increase in preterm birth and smoking a 3.4% decrease in birth weights.


CONCLUSIONS
Women of Hawaiian ancestry continue to smoke and use illicit drugs during pregnancy at significantly higher rates than women of other ethnic groups in Hawaii. In addition to the immediate effects on pregnancy, long-term adverse outcomes of in utero exposures of the offspring remain an important health disparity.
Department of Obstetrics, Gynecology and Women's Health, University of Hawaii, USA. tewright@hawaii.edu
Tricia E
TE
Wright
Elizabeth
E
Tam
D000328:Adult; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D009765:Obesity / Q000208:ethnology; D007752:Obstetric Labor, Premature / Q000208:ethnology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D012907:Smoking / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000208:ethnology*; D055815:Young Adult