Transitions in Smoking Across a Pregnancy: New Information from the Growing Up in New Zealand Longitudinal Study
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Introduction Maternal smoking remains a modifiable cause of adverse maternal and child health outcomes. This study investigated smoking transitions across pregnancy. Methods Data from the contemporary child cohort study Growing Up in New Zealand (n = 6822) were used to analyse smoking status across three points across a pregnancy: pre-pregnancy, during pregnancy and after pregnancy. Odds-ratios (OR) were calculated for maternal, socio-economic and pregnancy-related factors associated with each transition using multivariate logistic regression. Results The prevalence of smoking pre-pregnancy was 20.3%. The cessation rate during pregnancy was 48.5%, while the postpartum relapse rate was 36.0%. Heavy smokers were less likely to quit during pregnancy (OR 0.13, 95% CI 0.08–0.20), and more likely to relapse at 9 months (OR 2.63, CI 1.60–4.32), relative to light smokers. Women in households with another smoker were less likely to quit during pregnancy (OR 0.35, CI 0.25–0.48), and more likely to relapse postpartum (OR 2.00, CI 1.14–3.51), relative to women in a smoke-free household. Women without high school qualifications were less likely to quit during pregnancy than women with bachelor degrees (OR 0.21, CI 0.11–0.41) but no more likely to relapse. Maori women were less likely to quit during pregnancy than European women (OR 0.35, CI 0.25–0.49) but no more likely to relapse. Conclusion Heavy smokers and those with another smoker in the household are at high risk of smoking during pregnancy or relapsing after pregnancy. Decreasing smoking across a pregnancy therefore requires a focus on cessation in all households with heavy smokers of child-bearing age. The association between smoking and ethnicity may be confounded as it not consistent across the pregnancy.
KeywordsSmoking Pregnancy Postpartum Longitudinal study
We acknowledge the key role of the Ministry of Social Development in identifying the need for a longitudinal study that reflects the diversity of today’s New Zealand and for its ongoing support. Other agencies, as well as The University of Auckland, have contributed to the cost of the study to-date. These are: the Ministry of Health, the New Zealand Police, the Ministry of Justice, the Families Commission, the Children’s Commission, the Department of Labour, the Ministry of Education, Housing New Zealand and Sport and Recreation New Zealand. The funders have had no role in the design, analysis or writing of this article.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no competing interests.
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