孕期吸烟率、吸烟减少情况及戒烟情况与相关因素：巴西里约热内卢公立产科的一项横断面研究
Smoking prevalence, reduction, and cessation during pregnancy and associated factors: a cross-sectional study in public maternities, Rio de Janeiro, Brazil.
作者信息
Kale Pauline Lorena, Fonseca Sandra Costa, da Silva Kátia Silveira, da Rocha Penha Maria Mendes, Silva Rosana Garcia, Pires Alinne Christina Alves, Cavalcanti Maria de Lourdes Tavares, Costa Antonio Jose Leal, de Torres Tania Zdenka Guillén
机构信息
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Avenida Brigadeiro Trompowski, Rio de Janeiro (Hospital Universitário Clementino Fraga Filho, 5º andar), RJ, 21044-020, Brazil.
Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro (IESC/UFRJ), Avenida Horácio Macedo S/N -- Cidade Universitária, Rio de Janeiro, RJ, 21941-598, Brazil.
出版信息
BMC Public Health. 2015 Apr 19;15:406. doi: 10.1186/s12889-015-1737-y.
BACKGROUND
Smoking epidemic in Brazilian women has later onset, smaller magnitude, and slower decreasing trend, compared to men. Among pregnant women, smoking has an additional deleterious effect. The purpose of this study was to analyze smoking prevalence during pregnancy and associated factors, and to describe the frequency of smoking reduction and cessation in public maternities of Rio de Janeiro State, southeastern Brazil, in 2011.
METHODS
A cross-sectional study was conducted in two maternities located at public hospitals in two cities of the Rio de Janeiro state, Niterói (maternity A) and of Rio de Janeiro (maternity B). Data were gathered by interviews 12 hours after the delivery, and analyses of prenatal cards and medical records. Smoking prevalence according to maternal characteristics, adequacy of prenatal care, and proportions of smoking reduction and cessation during pregnancy were calculated. Factors associated to smoking during pregnancy were estimated by logistic regression analysis.
RESULTS
Smoking prevalence at maternity A (24.8%, 95% CI: 21.1-29.0) and maternity B (17.9%, 95% CI: 15.8-20.1) were high. Prevalence rates were greater in women aged 20-34 years, mainly without partner, multiparous and brown or black skin color. Low education (OR = 2.14, 95% CI 1.21, 3.79) and multiparity (OR = 3.48, 95% CI 1.78, 6.81), at maternity A; adolescence (OR = 0.44, 95% CI 0.26, 0.75), black skin color (OR = 1.71, 95% CI 1.06, 2.74), low education (OR = 1.61, 95% CI 1.08, 2.40), and multiparity (OR = 1.58, 95% CI 1.03, 2.44), at maternity B, were associated with smoking in multivariable analysis. Adequacy of prenatal care and smoking prevalence showed an inverse association. More than half of the smokers kept the smoking habits during pregnancy. Reduction occurred mainly between the 1(st) and 2(nd) trimesters of pregnancy.
CONCLUSION
Smoking prevalence during pregnancy was higher for multiparous and less educated women. Population and individual strategies for smoking prevention and control must include actions specific for women, especially during the reproductive period.
背景
与男性相比，巴西女性吸烟流行的起始时间较晚、规模较小且下降趋势较慢。在孕妇中，吸烟还有额外的有害影响。本研究的目的是分析孕期吸烟率及其相关因素，并描述2011年巴西东南部里约热内卢州公立医院产妇中减少吸烟和戒烟的频率。
方法
在里约热内卢州两个城市的公立医院的两家产科进行了一项横断面研究，分别是尼泰罗伊（产科A）和里约热内卢（产科B）。在分娩后12小时通过访谈收集数据，并分析产前检查卡和病历。计算根据产妇特征、产前护理充足程度的吸烟率，以及孕期减少吸烟和戒烟的比例。通过逻辑回归分析估计孕期吸烟的相关因素。
结果
产科A的吸烟率（24.8%，95%可信区间：21.1 - 29.0）和产科B的吸烟率（17.9%，95%可信区间：15.8 - 20.1）较高。20 - 34岁的女性吸烟率更高，主要是没有伴侣、经产妇以及棕色或黑色皮肤的女性。在产科A，低教育程度（比值比=2.14，95%可信区间1.21，3.79）和经产（比值比=3.48，95%可信区间1.78，6.81）与吸烟有关；在产科B，青春期（比值比=0.44，95%可信区间0.26，0.75）、黑色皮肤（比值比=1.71，95%可信区间1.06，2.74）、低教育程度（比值比=1.61，95%可信区间1.08，2.40）和经产（比值比=1.58，95%可信区间1.03，2.44）在多变量分析中与吸烟有关。产前护理的充足程度与吸烟率呈负相关。超过一半的吸烟者在孕期保持吸烟习惯。减少吸烟主要发生在妊娠的第1和第2孕期。
结论
经产妇和受教育程度较低的女性孕期吸烟率较高。预防和控制吸烟的人群和个体策略必须包括针对女性的特定行动，尤其是在生育期。
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