Abstract
Smoking during pregnancy causes various maternal and fetal health problems. Although there are considerable differences in maternal smoking proportions between localities, only a few studies have investigated the effects of regional characteristics on maternal smoking behavior. This study aimed to clarify the association between maternal smoking during pregnancy and individual and regional characteristics. We used data from a large nationwide birth cohort study in Japan that consisted of information on 20,267 women with children aged 3–4 months. The multilevel regression model was used to examine the association between smoking behavior during pregnancy and individual and regional characteristics. On multilevel analysis, late birth order, young age of the mother at birth, low birth weight, low economic status, husband’s smoking during pregnancy, maternal alcohol consumption during pregnancy, absence of a pregnancy counselor, and lack of participation in local events for childrearing were significantly associated with maternal smoking behavior during pregnancy at the individual level. Meanwhile, a high unemployment rate and a high number of nurseries were significantly associated with maternal smoking behavior during pregnancy at the regional level. In conclusion, we showed the relation between maternal smoking during pregnancy and the individual- and regional-level characteristics.
Highlights
Smoking during pregnancy has been suggested to cause various health problems to both the mother and the baby
Several variables were significantly associated with maternal smoking during pregnancy
With respect to regional factors, adjusted multilevel analyses revealed that unemployment rate, birthrate, and number of nurseries were significantly associated with maternal smoking behavior
Summary
Smoking during pregnancy has been suggested to cause various health problems to both the mother and the baby. It leads to low birth weight [1] and retarded intrauterine growth [1,2,3] and adversely affects the child’s growth after birth [4]. Origins of Health and Disease suggests that child development and even their adulthood may be affected by their mothers’ smoking during pregnancy [5]. The World Health Organization has reported a recent increase in smoking rates among women and projected the average women’s smoking rate to increase to 20% by 2025 [6]. Approximately 40% of women resume smoking after temporary cessation during pregnancy
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