title: Social Integration and Maternal Smoking: A Longitudinal Analysis of a National Birth Cohort.
abstract: Objectives Social support and engagement are related to smoking behavior in general populations, but it is unknown whether these measures of social integration as experienced by recent mothers are related to longitudinal maternal smoking patterns. The purpose of this study is, first, to describe longitudinal patterns of maternal smoking before, during, and after pregnancy through the early childhood parenting years, as well as variation in these patterns; and second, to examine these patterns in relation to social integration, emotional, behavioral, and sociodemographic factors. Methods Among 9050 mothers of the Early Childhood Longitudinal Study-Birth Cohort (a nationally representative probability sample of children born in 2001), we estimated trajectories of maternal smoking with a general growth mixture model and examined how baseline predictors are associated with these patterns over a 5-6 year period beginning 3 months prior to pregnancy. Results A 5-class solution identified trajectories of nonsmokers (70.5 %), temporary quitters (9.4 %), pregnancy-inspired quitters (3.3 %), delayed initiators (5.1 %), and persistent smokers (11.7 %). Modifiable risk factors included postpartum alcohol consumption and behavioral cues from co-resident smokers, while breastfeeding beyond 6 months and social engagement through religious service attendance were protective characteristics. Conclusions for Practice Prevention of and treatment for maternal perinatal and postpartum smoking is best informed by mothers' emotional, behavioral and sociodemographic characteristics. Religious service attendance, but not measures of social support or social engagement, was a protective factor for maternal smoking trajectories.
authors.affiliation: Public Health Research, NORC at the University of Chicago, 4350 East-West Highway, 8th Floor, Bethesda, MD, 20814, USA. mumford-elizabeth@norc.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mumford
authors.affiliation: Public Health Research, NORC at the University of Chicago, 4350 East-West Highway, 8th Floor, Bethesda, MD, 20814, USA.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Liu
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008423:Maternal Age; D009035:Mothers / Q000523:psychology*; D016487:Parenting; D049590:Postpartum Period; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D058992:Social Participation; D012944:Social Support
keywords: Community involvement; GGMM; Maternal smoking patterns; Social connectedness; Social engagement; Social support