Abstract
BackgroundGiven the health impacts of smoking during pregnancy and the opportunity for primary healthcare teams to encourage pregnant smokers to quit, our primary aim was to assess the completeness of gestational smoking status recording in primary care data and investigate whether completeness varied with women's characteristics. As a secondary aim we assessed whether completeness of recording varied before and after the introduction of the Quality and Outcomes Framework (QOF).MethodsIn The Health Improvement Network (THIN) database we calculated the proportion of pregnancies ending in live births or stillbirths where there was a recording of maternal smoking status for each year from 2000 to 2009. Logistic regression was used to assess variation in the completeness of maternal smoking recording by maternal characteristics, before and after the introduction of QOF.ResultsWomen had a record of smoking status during the gestational period in 28% of the 277,552 pregnancies identified. In 2000, smoking status was recorded in 9% of pregnancies, rising to 43% in 2009. Pregnant women from the most deprived group were 17% more likely to have their smoking status recorded than pregnant women from the least deprived group before QOF implementation (OR 1.17, 95% CI 1.10–1.25) and 42% more likely afterwards (OR 1.42, 95% CI 1.37–1.47). A diagnosis of asthma was related to recording of smoking status during pregnancy in both the pre-QOF (OR 1.63, 95% CI 1.53–1.74) and post-QOF periods (OR 2.08, 95% CI 2.02–2.15). There was no association between having a diagnosis of diabetes and recording of smoking status during pregnancy pre-QOF however, post-QOF diagnosis of diabetes was associated with a 12% increase in recording of smoking status (OR 1.12, 95% CI 1.05–1.19).ConclusionRecording of smoking status during pregnancy in primary care data is incomplete though has improved over time, especially after the implementation of the QOF, and varies by maternal characteristics and QOF-incentivised morbidities.
Highlights
Smoking during pregnancy has a well-documented negative effect on the health of a mother and her baby [1] and smoking cessation during pregnancy has been linked to a reduction in maternal and fetal complications in addition to its wider health benefits [2,3]
In the United Kingdom (UK) women must be registered with a GP in order to receive antenatal care and, most antenatal contacts are with midwives, an estimated 77% of women see their GPs first for confirmation of pregnancy before attending an antenatal booking appointment with a midwife [9]
Baseline characteristics We identified 215,703 women with pregnancies resulting in live births or stillbirths between January 2000 and December 2009
Summary
Smoking during pregnancy has a well-documented negative effect on the health of a mother and her baby [1] and smoking cessation during pregnancy has been linked to a reduction in maternal and fetal complications in addition to its wider health benefits [2,3]. In the United Kingdom (UK) women must be registered with a GP in order to receive antenatal care and, most antenatal contacts are with midwives, an estimated 77% of women see their GPs first for confirmation of pregnancy before attending an antenatal booking appointment with a midwife [9]. This first contact with a GP and subsequent visits during pregnancy could potentially be used as an opportunity for assessing and recording the smoking status of pregnant women. As a secondary aim we assessed whether completeness of recording varied before and after the introduction of the Quality and Outcomes Framework (QOF)
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call