School of Public Health, Brown University, Providence, Rhode Island, USA.
Rhode Island Department of Health, Providence, Rhode Island, USA.
Arch Gynecol Obstet. 2023 Oct;308(4):1207-1215. doi: 10.1007/s00404-022-06792-x. Epub 2022 Sep 29.
This cross-sectional study aimed to estimate the risks of adverse birth outcomes among pregnant smokers and the benefits of smoking cessation during pregnancy on birth outcomes across the United States.
We performed an analysis of 203,437 pregnant women using data collected by the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2012 to 2017. PRAMS uses questionnaires and birth certificates to collect information about the socio-demographic characteristics of pregnant women, smoking status before and during pregnancy, and birth outcomes. We assessed the relationship between self-reported smoking status during pregnancy and preterm birth, low birth weight, and small-for-gestational-age using multivariable logistic regression models.
In our study population, 80.43% of pregnant women never smoked, 10.55% of pregnant women quit smoking during pregnancy, and 9.02% continued smoking during pregnancy. Puerto Rico had the highest prevalence of non-smokers (94.12%), while West Virginia had the lowest prevalence of non-smokers (60.54%). Pregnant women who had a higher education level, were married, had less than 5 types of stress, and had government or private insurance before pregnancy had a higher prevalence of smokers who quit during pregnancy (quit smokers) than those that continued smoking (continuous smokers). Compared to non-smokers, continuous smokers had a significantly higher risk of low birth weight (AOR: 1.91, 95% CI 1.80, 2.03), preterm birth (AOR: 1.31, 95% CI 1.21, 1.41), and small-for-gestational-age (AOR: 2.22, 95% CI 2.07, 2.39). However, the relationships between quitting smoking and preterm birth and small-for-gestational-age were not significant.
Our models suggest that smoking cessation during pregnancy can prevent adverse birth outcomes by significantly reducing the risk of preterm birth and small-for-gestational-age to almost comparable to not smoking.
本横断面研究旨在估计美国孕妇吸烟的不良妊娠结局风险，以及孕妇在怀孕期间戒烟对妊娠结局的益处。
我们使用 2012 年至 2017 年期间妊娠风险评估监测系统（PRAMS）收集的数据对 203437 名孕妇进行了分析。PRAMS 使用问卷和出生证明收集有关孕妇社会人口统计学特征、怀孕前后吸烟状况以及妊娠结局的信息。我们使用多变量逻辑回归模型评估了怀孕期间自我报告的吸烟状况与早产、低出生体重和小于胎龄儿之间的关系。
在我们的研究人群中，80.43%的孕妇从不吸烟，10.55%的孕妇在怀孕期间戒烟，9.02%的孕妇继续吸烟。波多黎各的不吸烟者比例最高（94.12%），而西弗吉尼亚州的不吸烟者比例最低（60.54%）。文化程度较高、已婚、压力少于 5 种、怀孕前有政府或私人保险的孕妇中，戒烟的吸烟者（戒烟者）比继续吸烟的吸烟者（连续吸烟者）的比例更高。与不吸烟者相比，连续吸烟者低出生体重（AOR：1.91，95%CI 1.80，2.03）、早产（AOR：1.31，95%CI 1.21，1.41）和小于胎龄儿（AOR：2.22，95%CI 2.07，2.39）的风险显著更高。然而，戒烟与早产和小于胎龄儿之间的关系并不显著。
我们的模型表明，怀孕期间戒烟可以通过显著降低早产和小于胎龄儿的风险，使其接近不吸烟的水平，从而预防不良妊娠结局。
