title: Maternal-fetal attachment differentiates patterns of prenatal smoking and exposure.
abstract: OBJECTIVE
  Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers.
  
  
  METHODS
  Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers.
  
  
  RESULTS
  At 30 weeks, pregnancy quitters scored higher on the 'giving of self' subscale compared to persistent smokers (21.6±2.4 versus 19.9±2.9; p=.004). Maternal 'giving of self' also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9±2.9 versus 21.2±2.2; p=.002). Controlling for age, income, unemployment, gravida, and father's smoking status, 'giving of self' differentiated pregnancy quitters from persistent smokers [OR=5.144; 95% C.I. 1.509 - 17.538; B (SE)=1.638 (.626); p=.009].
  
  
  CONCLUSIONS
  Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.
authors: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA,; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA. Electronic address: suena.massey@northwestern.edu.
authors: Suena H
authors: SH
authors: Massey
authors: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA. Electronic address: mbublitz@lifespan.org.
authors: Margaret H
authors: MH
authors: Bublitz
authors: Department of Family Medicine, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA. Electronic address: Susanna_Magee@Brown.edu.
authors: Susanna R
authors: SR
authors: Magee
authors: Department of Pediatrics, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA. Electronic address: Amy_Salisbury@Brown.edu.
authors: Amy
authors: A
authors: Salisbury
authors: Schroeder Institute for Tobacco Research and Policy Studies, USA. Electronic address: rniaura@legacyforhealth.org.
authors: Raymond S
authors: RS
authors: Niaura
authors: Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA. Electronic address: lauriew@northwestern.edu.
authors: Lauren S
authors: LS
authors: Wakschlag
authors: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA. Electronic address: Laura_Stroud@Brown.edu.
authors: Laura R
authors: LR
authors: Stroud
mesh_terms: D000328:Adult; D000533:Altruism; D016022:Case-Control Studies; D003367:Cotinine / Q000032:analysis; D004645:Empathy; D005260:Female; D006801:Humans; D018811:Maternal Exposure; D033261:Maternal-Fetal Relations / Q000523:psychology*; D009769:Object Attachment; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011263:Pregnancy Trimester, Third; D012463:Saliva / Q000737:chemistry; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
chemical_list: D003367:Cotinine
keywords: Altruism; Attachment; Pregnancy smoking; Prenatal smoking; Smoking cessation
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