Abstract
Poor pregnancy and birth outcomes are major problems in the United States, and maternal smoking during pregnancy has been identified as one of the most preventable risk factors associated with these outcomes. This study examines less explored risk factors of smoking among underserved African American pregnant women. A cross-sectional survey was conducted at an outpatient obstetrics-gynecology clinic of an inner-city university hospital in Virginia from March 2009 through January 2011 in which pregnant women (N = 902) were interviewed at their first prenatal care visit. Survey questions included items related to women’s sociodemographic characteristics as well as their pregnancy history; criminal history; receipt of social services; child protective services involvement; insurance status; and history of substance abuse, domestic violence, and depression. Multiple logistic regression was conducted to calculate odds ratios and 95 % confidence intervals depicting the relationship between these factors and smoking during pregnancy. The analysis reported that maternal age [OR = 1.08, 95 % CI = 1.05–1.12], less than high school education [OR = 4.30, 95 % CI = 2.27–8.14], unemployed [OR = 2.33, 95 % CI = 1.35–4.04], criminal history [OR = 1.66, 95 % CI = 1.05–2.63], receipt of social services [OR = 2.26, 95 % CI = 1.35–3.79] alcohol use [OR = 2.73, 95 % CI = 1.65–4.51] and illicit drug use [OR = 1.97, 95 % CI = 1.04–3.74] during pregnancy were statistically significant risk factors associated with smoking during pregnancy. In addition to the well known risk factors, public health professionals should be aware that criminal history and receipt of social services are important factors associated with smoking during pregnancy. Social service providers such as WIC and prisons and jails may offer a unique opportunity for education and cessation interventions during the preconception or interconception period.
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Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., et al. (2010). Infant morbidity and mortality attributable to prenatal smoking in the U.S. American Journal of Preventive Medicine, 39, 45–52.
Lanari, M., Giovannini, M., Giuffré, L., et al. (2002). Prevalence of respiratory syncytial virus infection in Italian infants hospitalized for acute lower respiratory tract infections, and association between respiratory syncytial virus infection risk factors and disease severity. Pediatric Pulmonology, 33, 458–465.
Nuorti, J. P., Butler, J. C., Farley, M. M., et al. (2000). Cigarette smoking and invasive pneumococcal disease. New England Journal of Medicine, 342, 681–689.
Ey, J. L., Holberg, C. J., Aldous, M. B., et al. (1995). Passive smoke exposure and otitis media in the first year of life. Pediatrics, 95, 670–677.
Burr, M. L., Anderson, H. R., Austin, J. B., et al. (1999). Respiratory symptoms and home environment in children: A national survey. Thorax, 54(27–32), 9.
Wisborg, K., Kesmodel, U., Henriksen, T. B., et al. (2001). Exposure to tobacco smoke in utero and the risk of stillbirth and death in the first year of life. American Journal of Epidemiology, 154, 322–327.
Tong, V. T., Fones, J. R., Dietz, P. M., et al. (2009). Trends in smoking before, during and after pregnancy—Pregnancy risk assessment monitoring system (PRAMS), United States, 31 Sites, 2000–2005. MMWR., 58(SS04), 1–29.
Cnattingius, S., Lindmark, G., & Meirik, O. (1992). Who continues to smoke while pregnant? Journal of Epidemiology Community Health, 46, 218–221.
Chasnoff, I. J., Neuman, K., Thornton, C., et al. (2001). Screening for substance use in pregnancy: A practical approach for the primary care physician. American Journal of Obstetrics and Gynecology, 184, 752–758.
Svikis, D., Henningfield, J., Gazaway, P., et al. (1997). Tobacco use for identifying pregnant women at risk of substance abuse. Journal of Reproductive Medicine, 42, 299–302.
Gilman, S. E., Breslau, J., Subramanian, S. V., et al. (2008). Social factors, psychopathology, and maternal smoking during pregnancy. American Journal of Public Health, 98, 448–453.
Agrawal, A., Knopik, V. S., Pergadia, M. L., et al. (2008). Correlates of cigarette smoking during pregnancy and its genetic and environmental overlap with nicotine dependence. Nicotine and Tobacco Research, 10, 567–578.
Hammarstrom, A., & Janlert, U. (2003). Unemployment—an important predictor for future smoking: a 14-year follow-up study of school leavers. Scandinavian Journal of Public Health, 31, 229–232.
Zhu, S. H., & Valbo, A. (2002). Depression and smoking during pregnancy. Addictive Behaviors, 27, 649–658.
Linares, T. J., Heil, S. H., Higgins, S. T., et al. (2009). Depressive symptoms predict smoking status among pregnant women. Addictive Behaviors, 34, 705–708.
Goedhart, G., Van der Wal, M. F., Cuijpers, P., et al. (2009). Psychosocial problems and continued smoking during pregnancy. Addictive Behaviors, 34, 403–406.
Durrah, T. L., & Rosenberg, T. J. (2004). Smoking among female arrestees: Prevalence of daily smoking and smoking cessation efforts. Addictive Behaviors, 29, 1015–1019.
Staton, M., Leukefeld, C., & Webster, J. M. (2003). Substance use, health, and mental health: Problems and service utilization among incarcerated women. International Journal of Offender Therapy and Comparative Criminology, 47, 224–239.
Taylor, B. G., Newton, P. J., & Brownstein, H. H. (2003). Drug use among female arrestees. In Arrestee Drug Abuse Monitoring (ADAM) 2000 Annual Report (pp. 1–2). Washington, DC: National Institute of Justice.
Greenfield, L., & Snell, L. (1999). Women offenders. Washington, DC: Bureau of justice statistic. (NCJ Publication No. 175688). http://bjs.ojp.usdoj.gov/content/pub/pdf/wo.pdf. Accessed 16 Feb 2012.
Knight, M., & Plugge, E. (2005). Risk factors for adverse perinatal outcomes in imprisoned pregnant women: A systematic review. BMC Public Health, 5, 111.
Knight, M., & Plugge, E. (2005). The outcomes of pregnancy among imprisoned women: A systematic review. British Journal of Obstetrics and Gynaecology, 112, 1467–1474.
Masho, S. W., Keyser-Marcus, L., Varner, S. B., et al. (2011). Addressing perinatal disparities using community-based participatory research: Data into action. Journal of Community Psychology, 39, 292–302.
Joyce, T., Racine, A., & Yunzal-Butler, C. (2008). Reassessing the WIC effect: Evidence from the pregnancy nutrition surveillance system. Journal of Policy Analysis and Management, 27(2), 277–303.
Feldhaus, K. M., Koziol-McLain, J., Amsbury, H. L., et al. (1997). Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. JAMA, 277, 1357–1361.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41, 1284–1292.
Bonollo, D. P., Zapka, J. G., Stoddard, A. M., et al. (2002). Treating nicotine dependence during pregnancy and postpartum: Understanding clinician knowledge and performance. Patient Education and Counseling, 48, 265–274.
Pullon, S., Webster, M., McLeod, D., et al. (2004). Smoking cessation and nicotine replacement therapy in current primary maternity care. Australian Family Physician, 33, 94–96.
Lancaster, C. A., Gold, K. J., Flynn, H. A., et al. (2010). Risk factors for depressive symptoms during pregnancy: A systematic review. American Journal of Obstetrics and Gynecology, 202, 5–14.
Bowen, A., & Muhajarine, N. (2006). Prevalence of antenatal depression in women enrolled in an outreach program in Canada. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 491–498.
Flynn, H. A., Marcus, S. M., Barry, K. L., et al. (2003). Rates and correlates of alcohol use among pregnant women in obstetrics clinics. Alcoholism, Clinical and Experimental Research, 27, 81–87.
Vander Weg, M. W., Ward, K. D., Scarinci, I. C., et al. (2004). Smoking-related correlates of depressive symptoms in low-income pregnant women. American Journal of Health Behavioural, 28, 510–521.
Ward, K. D., Vander Weg, M. W., Sell, M. A., et al. (2006). Characteristics and correlates of quitting among black and white low income pregnant smokers. American Journal of Health Behavioural, 30, 651–662.
Hoffman, S., & Hatch, M. C. (2000). Depressive symptomatology during pregnancy: Evidence for an association with decreased fetal growth in pregnancies of lower social class women. Health Psychology, 19, 535–543.
Gierisch, J. M., Bastian, L. A., Calhoun, P. S. et al. (2010). Comparative effectiveness of smoking cessation treatments for patients with depression: A systematic review and meta-analysis of the evidence. VA-ESP Project #09-010. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0009495/pdf/TOC.pdf. Accessed 16 Feb 2012.
McFarlane, J., Parker, B., & Soeken, K. (1996). Physical abuse, smoking, and substance use during pregnancy: Prevalence, interrelationships, and effects on birth weight. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 25, 313–320.
Jesse, D. E., Graham, M., & Swanson, M. (2006). Psychosocial and spiritual factors associated with smoking and substance use during pregnancy in African American and White low-income women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 68–77.
Ringel, J. S., & Evans, W. N. (2001). Cigarette taxes and smoking during pregnancy. American Journal of Public Health, 91, 1851–1856.
Van Walbeek, C. (2010). A simulation model to predict the fiscal and public health impact of a change in cigarette excise taxes. Tobacco Control, 19, 31–36.
Gilmore, A. B., Branston, J. R., & Sweanor, D. (2010). The case for OFSMOKE: How tobacco price regulation is needed to promote the health of markets, government revenue and the public. Tobacco Control, 19, 423–430.
Rivara, F. P., Ebel, B. E., Garrison, M. M., et al. (2004). Prevention of smoking-related deaths in the United States. American Journal of Preventive Medicine, 27, 118–125.
Dietz, P. M., Homa, D., England, L. J., et al. (2011). Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. American Journal of Epidemiology, 173, 355–359.
Acknowledgments
This study was supported by Cooperative Agreement Number 5U58DP000983 from the Centers for Disease Control and Prevention and by NIH 5 P60 MD002256-03 from the National Center on Minority Health and Health Disparities. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the sponsors.
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Masho, S.W., Bishop, D.L., Keyser-Marcus, L. et al. Least Explored Factors Associated with Prenatal Smoking. Matern Child Health J 17, 1167–1174 (2013). https://doi.org/10.1007/s10995-012-1103-y
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DOI: https://doi.org/10.1007/s10995-012-1103-y