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Smoking Cessation and Pregnancy: Timing of Cessation Reduces or Eliminates the Effect on Low Birth Weight

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Abstract

Background

Women who smoke cigarettes while pregnant are at elevated risk of having low birth weight infants (LBW, < 2500 g) which increases risks of infant mortality and morbidity, including chronic conditions later in life.

Objective

Smoking cessation during pregnancy can reduce the risk of poor birth outcomes. However, the effect that timing of smoking cessation has on the reduction of poor birth outcomes in term pregnancies is unknown.

Study Design

This retrospective cohort study used birth certificate data from Missouri singleton, full-term, live births from 2010 to 2012 (N = 179,653) to examine the rates and timing of smoking cessation during pregnancy on birthweight. Smoking exposure was categorized as non-smoker, preconception cessation, first trimester cessation, second trimester cessation, and smoker. The outcome was low birth weight (LBW). Covariates included maternal race/ethnicity, age, education level, type of payment for the delivery, marital status, paternal acknowledgement, prenatal sexually transmitted infection (STI), comorbidities, and body mass index. Bivariate and multivariable analyses were used to assess relationships between smoking and LBW status.

Results

Preconception cessation did not have a statistically higher risk for LBW than mothers who never smoked (aOR 1.12; 95% CI 0.98, 1.28). First trimester cessation (aOR 1.26; 95% CI 1.05, 1.52), second trimester cessation (aOR 2.00; 95% CI 1.60, 2.67), and smoker (aOR 2.46; 95% CI 2.28, 2.67) had increasing odds for LBW relative to mothers who did not smoke. All covariates had significant relationships with the smoking exposure.

Conclusion

Preconception cessation yielded LBW rates comparable to non-smokers. The risk for LBW increased as smoking continued throughout pregnancy among full term births, an important new finding in contrast with other studies.

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References

  • Bennett, D. (2001). How can i deal with missing data in my study? Australian and New Zealand Journal of Public Health, 25(5), 464–469.

    Article  CAS  Google Scholar 

  • Beyerlein, A., Ruckinger, S., Toschke, A., Rosario, A., & VoonKries, R. (2011). Is low birth weight in the causal pathway of association between maternal smoking in pregnancy and higher BMI in the offspring? European Journal of Epidemiology, 26, 41–420.

    Article  Google Scholar 

  • Blatt, K., Moore, E., Chen, A., VanHook, S., & DeFranco, E. (2015). Association of reported trimester-specific smoking cessation with fetal growth restriction. Obstetrics and Gynecology, 125, 1452–1459.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carter, S., Percival, T., Paterson, J., & Williams, M. (2006). Maternal smoking: Risks related to maternal asthma and reduced birth weight in a Pacific Island birth cohort in New Zealand. The New Zealand Medical Journal, 119(1238), 19–30.

    Google Scholar 

  • Center for Tobacco and Policy Research (CTPR). (2007). Where do we stand? Characteristics of Missouri Tobacco Users, 2007. Retrieved February 8, 2016, from https://mffh.org/wordpress/wp-content/uploads/2016/04/Characteristics_of_Missouri_Tobacco_Users.pdf.

  • Cnattingius, S., Granath, F., Petersson, G., & Harlow, B. L. (1999). The influence of gestational age and smoking habits on the risk of subsequent preterm deliveries. New England Journal of Medicine, 341(13), 943–948.

    Article  CAS  PubMed  Google Scholar 

  • Curtin, S., & Mathews, T. (2016). Smoking prevalence and cessation before and during pregnancy: Data from the birth certificate, 2014. National Vital Statistics Reports, 65, 1–13.

    PubMed  Google Scholar 

  • Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., Tong, V. T., Farr, S. L., & Callaghan, W. M. (2010). Infant morbidity and mortality attributable to prenatal smoking in the US. American Journal of Preventive Medicine, 39(1), 45–52.

    Article  PubMed  Google Scholar 

  • Grzeskowiak, L. E., Hodyl, N. A., Stark, M. J., Morrison, J. L., & Clifton, V. L. (2015). Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age. Journal of Developmental Origins of Health and Disease, 6(06), 485–492.

    Article  CAS  PubMed  Google Scholar 

  • Healthy People. (2020). Washington, DC: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved May 5, 2017, from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

  • Kim, D., & Saada, A. (2013). The social determinants of infant mortality and birth outcomes in western developed nations: A cross-country systematic review. International Journal of Environmental Research and Public Health IJERPH, 10(6), 2296–2335.

    Article  PubMed  Google Scholar 

  • Ko, T., Tsai, L., Chu, L., Yeh, S., Leung, C., Chen, C., et al. (2014). Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: A birth cohort study. Pediatrics & Neonatology, 55(1), 20–27.

    Article  Google Scholar 

  • Lamminpää, R., Vehviläinen-Julkunen, K., Gissler, M., & Heinonen, S. (2013). Smoking among older childbearing women—a marker of risky health behavior a registry-based study in Finland. BMC Public Health, 13(1), 1179.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martin, J. A. (2015). Measuring gestational age in vital statistics data: Transitioning to the obstetric estimate [Abstract]. National Vital Statistics Reports, 64(5), 1–20.

    PubMed  Google Scholar 

  • Mathews, T., & MacDorman, M. (2013). Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Report, 60(5), 1–28.

    Google Scholar 

  • Mazurek, J. M., & England, L. J. (2016). Cigarette smoking among working women of reproductive age—United States, 2009–2013. Nicotine & Tobacco Research, ntv292. Chicago.

  • Missouri Information for Community Assessment (MICA). (2014). Birth outcomes. Retrieved August 12, 2016, from http://health.mo.gov/data/mica//mica/birth.php.

  • Mohlman, M. K., & Levy, D. T. (2016). Disparities in maternal child and health outcomes attributable to prenatal tobacco use. Maternal and Child Health Journal, 20, 701–709.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moore, E., Blatt, K., Chen, A., Van Hook, J., & DeFranco, E. (2015). Relationship of trimester-specific smoking patterns and risk of preterm birth. Obstetrics and Gynecology, 125, 109.e1–109.e6.

    Article  Google Scholar 

  • Ngui, E., Cortright, A., & Blair, K. (2009). An investigation of paternity status and other factors associated with racial and ethnic disparities in birth outcomes in Milwaukee, Wisconsin. Journal of Maternal and Child Health, 13, 467–478.

    Article  Google Scholar 

  • Osterman, M. J., Martin, J. A., Matthews, T. J., & Hamilton, B. E. (2011). Expanded data from the new birth certificate, 2008. National Vital Statistics Reports, 59(7), 1–28.

    PubMed  Google Scholar 

  • Pereira, P., Da Mata, F., Figueiredo, A., de Andrade, K., & Pereira, M. (2017). Maternal active smoking during pregnancy and low birth weight in the Americas: A systematic review and meta-analysis. Nicotine & Tobacco Research, 19, 497–505.

    Article  Google Scholar 

  • Polakowski, L., Akinbami, L., & Mendola, P. (2009). Prenatal smoking cessation and the risk of delivery preterm and small for gestational age newborns. Obstetrics and Gynecology, 114, 318–325.

    Article  PubMed  Google Scholar 

  • Tobacco Free Kids. (2017). State cigarette excise tax rates and rankings. Retrieved May 5, 2017, from https://www.tobaccofreekids.org/research/factsheets/pdf/0097.pdf.

  • U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2013). Child Health USA 2013.

  • Vardavas, C., Chatzi, L., Patelarou, E., Plana, E., Sarri, K., Kafatos, A., et al. (2009). Smoking and smoking cessation during early pregnancy and its effect on adverse pregnancy outcomes and fetal growth. European Journal of Pediatrics, 169, 741–748.

    Article  PubMed  Google Scholar 

  • Wallace, J., Aland, K., Blatt, K., Moore, E., & DeFranco, E. (2017). Modifying the risk of recurrent preterm birth: Influence of trimester-specific changes in smoking behaviors. American Journal of Obstetrics and Gynecology, 216, 310.e1–310.e8.

    Article  Google Scholar 

  • Xaverius, P., Alman, C., Holtz, L., & Yarber, L. (2015). Risk factors associated with very low birth weight in a large urban area, stratified by adequacy of prenatal care. Maternal and Child Health Journal, 20, 623–629.

    Article  Google Scholar 

  • Yan, J., & Groothuis, A. (2015). Timing of prenatal smoking cessation or reduction and infant birthweight: Evidence from the United Kingdom Millennium Cohort Study. Maternal Child Health Journal, 19, 447–458.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This project was completed as part of the epidemiology concentration’s MPH degree requirements at Saint Louis University, College for Public Health and Social Justice, a course co-instructed by Pamela K. Xaverius, PhD, MBA and Joanne Salus, MPH. The data used in this manuscript was acquired from the Missouri Department of Health and Senior Services (DHSS). The contents of this document including data analysis, interpretation or conclusions are solely the responsibility of the authors and do not represent the official views of DHSS or Saint Louis University.

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Correspondence to Pamela K. Xaverius.

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Xaverius, P.K., O’Reilly, Z., Li, A. et al. Smoking Cessation and Pregnancy: Timing of Cessation Reduces or Eliminates the Effect on Low Birth Weight. Matern Child Health J 23, 1434–1441 (2019). https://doi.org/10.1007/s10995-019-02751-2

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  • DOI: https://doi.org/10.1007/s10995-019-02751-2

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