title: Estimating the impact of smoking cessation during pregnancy: the San Bernardino County experience.
abstract: We examined the relation between maternal smoking and adverse infant outcomes [low birth weight (LBW), and preterm birth (PTB)] during 2007-2008 in San Bernardino County, California-the largest county in the contiguous United States which has one of the highest rates of infant mortality in California. Using birth certificate data, we identified 1,430 mothers in 2007 and 1,355 in 2008 who smoked during pregnancy. We assessed the effect of never smoking and smoking cessation during pregnancy relative to smoking during pregnancy for the 1,843/1,798 LBW, and 3,480/3,238 PTB's recorded for 2007/2008, respectively. To describe the effect of quitting smoking during pregnancy, we calculated the exposure impact number for smoking during pregnancy. Major findings are: (1) relative to smoking during pregnancy, significantly lower risk of LBW among never smoking mothers [OR, year: 0.56, 2007; 0.54, 2008] and for smoking cessation during pregnancy [0.57, 2007; 0.72, 2008]; (2) relative to smoking during pregnancy, significantly lower risk of PTB was found for never smoking mothers [0.68, 2007; 0.68, 2008] and for smoking cessation during pregnancy [0.69, 2007; 0.69, 2008]; (3) an exposure impact assessment indicating each LBW or PTB outcome in the county could have been prevented either by at least 35 mothers quitting smoking during pregnancy or by 25 mothers being never smokers during pre-pregnancy. Our findings identify an important burden of adverse infant outcomes due to maternal smoking in San Bernardino County that can be effectively decreased by maternal smoking cessation.
authors.affiliation: Loma Linda University School of Public Health, Loma Linda, CA, USA. mbatech@llu.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Batech
authors.forename: Serena
authors.initials: S
authors.lastname: Tonstad
authors.forename: Jayakaran S
authors.initials: JS
authors.lastname: Job
authors.forename: Richard
authors.initials: R
authors.lastname: Chinnock
authors.forename: Bryan
authors.initials: B
authors.lastname: Oshiro
authors.forename: T
authors.initials: T
authors.lastname: Allen Merritt
authors.forename: Gretchen
authors.initials: G
authors.lastname: Page
authors.forename: Pramil N
authors.initials: PN
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D000328:Adult; D001719:Birth Certificates; D002140:California; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult
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