title: The Impact of Prior Poor Birth Outcomes on Smoking Behavior on Subsequent Pregnancies: Analysis of the National PRAMS Data.
abstract: OBJECTIVE
  The link between cigarette smoking and poor birth outcomes has been well established. However, there is paucity of research investigating the effect of previous history of poor birth outcomes on smoking behavior during subsequent pregnancies. The present study seeks to determine whether a previous preterm or low birth weight delivery impacts maternal smoking during the subsequent pregnancy.
  
  
  METHODS
  Data from the National Pregnancy Risk Assessment Monitoring System (PRAMS) was analyzed. Multiparous women who currently had singleton birth were included in the analysis (N = 137,297). Previous poor birth outcome and smoking were defined based on the PRAMS question that asked women whether their immediate previous baby was born preterm or low birth weight and if they smoked during the index pregnancy.
  
  
  RESULTS
  Approximately 16.3 % of the women who reported previous poor birth outcome also reported smoking during the subsequent pregnancy. Multiple logistic regression analysis revealed that women who had previous poor birth outcome had 22 % higher odds of smoking during the subsequent pregnancy. Similarly, the odds of smoking during pregnancy were 30 and 13 % higher among women who had previous low birth weight and preterm birth, respectively.
  
  
  CONCLUSIONS
  Women who experienced previous preterm or low birth weight baby had higher prevalence of smoking during the subsequent pregnancy. The occurrence of a preterm/low birth weight may present a critical intervention point for providers to educate women on the risks of repeated poor birth outcomes and provide intervention programs to address high-risk behaviors.
authors.affiliation: Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, 23298, USA.|Virginia Department of Health, Richmond, VA, USA.
authors.forename: Sara B
authors.initials: SB
authors.lastname: Varner
authors.affiliation: Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, 23298, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Ihongbe
authors.affiliation: Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, 23298, USA. swmasho@vcu.edu.|Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA. swmasho@vcu.edu.|Institute of Women's Health, Virginia Commonwealth University, Richmond, VA, USA. swmasho@vcu.edu.
authors.forename: Saba W
authors.initials: SW
authors.lastname: Masho
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010298:Parity; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care; D015995:Prevalence; D012044:Regression Analysis; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Interconception health; Low birth weight; PRAMS; Perinatal smoking; Preterm birth