Smoking in pregnancy in West Virginia: does cessation/reduction improve perinatal outcomes?
To determine if pregnant women decreasing/quitting tobacco use will have improved fetal outcomes. Retrospective analysis of pregnant smokers from 6/1/2006-12/31/2007 who received prenatal care and delivered at a tertiary medical care center in West Virginia. Variables analyzed included birth certificate data linked to intervention program survey data. Patients were divided into four study groups: <8 cigarettes/day-no reduction, <8 cigarettes/day-reduction, ≥8 cigarettes/day-no reduction, and ≥8 cigarettes/day-reduction. Analysis performed using ANOVA one-way test for continuous variables and Chi-square for categorical variables. Inclusion criteria met by 250 patients. Twelve women (4.8%) quit smoking; 150 (60%) reduced; 27 (10.8%) increased; and 61 (24.4%) had no change. Comparing the four study groups for pre-term births (<37 weeks), 25% percent occurred in ≥8 no reduction group while 10% occurred in ≥8 with reduction group (P = 0.026). The high rate of preterm birth (25%) in the non-reducing group depended on 2 factors: (1) ≥8 cigarettes/day at beginning and (2) no reduction by the end of prenatal care. Finally, there was a statistically significant difference in birth weights between the two groups: ≥8 cigarettes/day with no reduction (2,872.6 g) versus <8 cigarettes/day with reduction (3,212.4 g) (P = 0.028). Smoking reduction/cessation lowered risk of pre-term delivery (<37 weeks) twofold. Encouraging patients who smoke ≥8 cigarettes/day during pregnancy to decrease/quit prior to delivery provides significant clinical benefit by decreasing the likelihood of preterm birth. These findings support tobacco cessation efforts as a means to improve birth outcome.
Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, WV 25302, USA. djseybold@camc.org
Dara J
DJ
Seybold
Mike
M
Broce
Eric
E
Siegel
Joseph
J
Findley
Byron C
BC
Calhoun
D000328:Adult; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires; D014903:West Virginia / Q000453:epidemiology; D055815:Young Adult
Obstet Gynecol. 2007 Apr;109(4):875-83
17400849
Obstet Gynecol. 1996 Feb;87(2):163-8
8559516
Am J Epidemiol. 2007 Sep 1;166(5):571-5
17566062
BMJ. 2009 Mar 26;338:b1081
19325177
Acta Paediatr. 2007 Mar;96(3):377-82
17407460
Thorax. 2007 Aug;62(8):714-7
17356057
Paediatr Perinat Epidemiol. 2007 Sep;21(5):441-7
17697074
J Reprod Med. 1994 Oct;39(10):769-76
7837122
Am J Epidemiol. 2007 Aug 1;166(3):289-95
17548787
BJOG. 2007 Jun;114(6):699-704
17516961
Soc Sci Med. 1995 Jul;41(2):227-33
7667684
J Fam Pract. 1994 Mar;38(3):262-6
8126407
J Am Acad Child Adolesc Psychiatry. 2007 Mar;46(3):362-369
17314722
Am J Epidemiol. 2007 May 15;165(10):1207-15
17329715
Acta Paediatr. 2007 Jul;96(7):1030-5
17498194
Acta Paediatr. 2007 Mar;96(3):383-6
17407461
Cochrane Database Syst Rev. 2009 Jul 08;(3):CD001055
19588322
Epidemiology. 2007 Mar;18(2):226-33
17202867
MMWR Surveill Summ. 2009 May 29;58(4):1-29
19478726
Am J Epidemiol. 1998 Dec 1;148(11):1048-54
9850126
Pediatr Res. 2007 Apr;61(4):462-6
17515872
Obstet Gynecol. 2005 Nov;106(5 Pt 1):986-91
16260516
Paediatr Perinat Epidemiol. 1997 Apr;11(2):140-51
9131707
Eur J Neurosci. 2007 Feb;25(3):611-7
17298594
Epidemiology. 2007 Mar;18(2):220-5
17202869
Am J Perinatol. 2007 Mar;24(3):191-6
17372859
Nicotine Tob Res. 2008 Jun;10(6):969-74
18584460
Croat Med J. 2005 Oct;46(5):832-7
16158480
Matern Child Health J. 2003 Dec;7(4):219-27
14682499
Epidemiology. 2006 Sep;17(5):524-30
16878043