Varner Sara B, Ihongbe Timothy, Masho Saba W
Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, P.O. Box 980212, Richmond, VA, 23298, USA.
Virginia Department of Health, Richmond, VA, USA.
Matern Child Health J. 2016 Mar;20(3):583-92. doi: 10.1007/s10995-015-1857-0.
The link between cigarette smoking and poor birth outcomes has been well established. However, there is paucity of research investigating the effect of previous history of poor birth outcomes on smoking behavior during subsequent pregnancies. The present study seeks to determine whether a previous preterm or low birth weight delivery impacts maternal smoking during the subsequent pregnancy.
Data from the National Pregnancy Risk Assessment Monitoring System (PRAMS) was analyzed. Multiparous women who currently had singleton birth were included in the analysis (N = 137,297). Previous poor birth outcome and smoking were defined based on the PRAMS question that asked women whether their immediate previous baby was born preterm or low birth weight and if they smoked during the index pregnancy.
Approximately 16.3 % of the women who reported previous poor birth outcome also reported smoking during the subsequent pregnancy. Multiple logistic regression analysis revealed that women who had previous poor birth outcome had 22 % higher odds of smoking during the subsequent pregnancy. Similarly, the odds of smoking during pregnancy were 30 and 13 % higher among women who had previous low birth weight and preterm birth, respectively.
Women who experienced previous preterm or low birth weight baby had higher prevalence of smoking during the subsequent pregnancy. The occurrence of a preterm/low birth weight may present a critical intervention point for providers to educate women on the risks of repeated poor birth outcomes and provide intervention programs to address high-risk behaviors.
吸烟与不良出生结局之间的联系已得到充分证实。然而，关于既往不良出生结局对后续妊娠期间吸烟行为影响的研究却很少。本研究旨在确定既往早产或低出生体重分娩是否会影响后续妊娠期间的孕妇吸烟情况。
对来自国家妊娠风险评估监测系统（PRAMS）的数据进行分析。分析纳入了目前生育单胎的经产妇（N = 137,297）。既往不良出生结局和吸烟情况是根据PRAMS的问题来定义的，该问题询问女性其前一个婴儿是否早产或低出生体重，以及她们在本次妊娠期间是否吸烟。
报告有既往不良出生结局的女性中，约16.3%也报告在后续妊娠期间吸烟。多因素logistic回归分析显示，有既往不良出生结局的女性在后续妊娠期间吸烟的几率高出22%。同样，既往有低出生体重和早产的女性在妊娠期间吸烟的几率分别高出30%和13%。
既往有早产或低出生体重婴儿的女性在后续妊娠期间吸烟的患病率较高。早产/低出生体重的发生可能为医护人员提供了一个关键的干预点，以便对女性进行关于反复出现不良出生结局风险的教育，并提供干预项目来解决高危行为。
