title: Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety.
abstract: Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum.
  
  
  
  This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women's pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis.
  
  
  
  In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25-17.93) and third trimester (OR = 4.03; 95 % CI = 1.76-9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26-35 years (OR = 1.71; 95 % CI = 1.27-2.29).
  
  
  
  Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.
authors.affiliation: School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shu-Chuan
authors.initials: SC
authors.lastname: Weng
authors.affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.|Mackay Memorial Hospital, New Taipei, Taiwan.|MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
authors.forename: Jian-Pei
authors.initials: JP
authors.lastname: Huang
authors.affiliation: School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.|Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Huang
authors.affiliation: Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan.
authors.forename: Tony Szu-Hsien
authors.initials: TS
authors.lastname: Lee
authors.affiliation: School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan. yichen@tmu.edu.tw.
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D011264:Pregnancy Trimesters; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013624:Taiwan / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Depression; Pregnancy; Secondhand smoke exposure; Smoking; Suicidal ideation