Tobacco control policies and perinatal health: a national quasi-experimental study.
We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000-2011; registration: ClinicalTrials.gov NCT02189265). Primary outcome measures were: perinatal mortality, preterm birth, and being small-for-gestational age (SGA). The association with timing of the tobacco control policies was investigated using interrupted time series logistic regression analyses with adjustment for confounders. Among 2,069,695 singleton births, there were 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births. The 2004 policies were not associated with significant changes in the odds of developing any of the primary outcomes. After the 2008 policy change, a -4.4% (95% CI -2.4; -6.4, p < 0.001) decrease in odds of being SGA was observed. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to bars and restaurants in conjunction with a tax increase and mass media campaign.
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands.
Myrthe J
MJ
Peelen
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.|School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, the Netherlands.
Aziz
A
Sheikh
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands.
Marjolein
M
Kok
Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, the Netherlands.
Petra
P
Hajenius
Department of Paediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands.
Luc J
LJ
Zimmermann
Department of Paediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands.
Boris W
BW
Kramer
The Netherlands Perinatal Registry, Utrecht, the Netherlands.
Chantal W
CW
Hukkelhoven
Division of Neonatology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, the Netherlands.
Irwin K
IK
Reiss
The Robinson Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
Ben W
BW
Mol
Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.|School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, Maastricht, the Netherlands.|Department of Paediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands.|Division of Neonatology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, the Netherlands.
Jasper V
JV
Been
D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D009426:Netherlands; D065228:Non-Randomized Controlled Trials as Topic; D016017:Odds Ratio; D018743:Perinatal Care; D054238:Perinatal Mortality; D011247:Pregnancy; D047928:Premature Birth; D012042:Registries; D000074606:Smoking Prevention / Q000331:legislation & jurisprudence*; D013660:Taxes / Q000331:legislation & jurisprudence; D017132:Workplace