Abstract
Gestational smoking is associated with various adverse maternal and fetal outcomes. Over the last three decades, despite considerable advances in tobacco control policy in Brazil, gestational smoking has caused a considerable number of fetal deaths and disabilities. The aim of this study is to estimate the prevalence of pre-gestational and gestational smoking and to identify the factors associated with smoking cessation up to the 20th gestational week. Methods: “Birth in Brazil” was a nationwide hospital-based study conducted from February 2011 to October 2012. Smoking prevalence and smoking cessation during pregnancy was estimated through face-to-face interviews with postpartum women during hospitalization for birth care. We performed multivariate logistic regression to verify the factors associated with smoking cessation up to the 5th month of pregnancy. Results: prevalence of pre-gestational smoking of 16.1% (CI 95% 15.3%-16.9%); prevalence of smoking any time during pregnancy of 9.6% (CI 95% 9.0%-10.3%); and prevalence of smoking cessation up to the 5th month of pregnancy of 56.7% (CI 95% 54.0%-59.4%). The factors associated with smoking cessation were residence in the North, Northeast, and Central-West of Brazil, having received at least one prenatal consultation (OR 3.51 CI 95% 1.85–6.67), more years of schooling (15 or more vs less than 7 years of schooling OR 5.54 CI 95% 2.97–10.34), living with a partner (OR 1.35 CI 95% 1.01–1.79), no children prior to the index pregnancy (OR 2.77 CI 95% 2.13–3.61), and absence of alcohol use (1.74 CI 95% 1.39–2.18) or of suspected alcohol abuse (OR 1.62 CI 95% 1.07–2.45). Conclusion: The estimated smoking rate during pregnancy in Brazil is still high and is associated with factors of increased maternal social vulnerability, which may contribute to the increased occurrence of unfavorable perinatal outcomes.
Highlights
Smoking during pregnancy is a major public health problem, associated with various adverse maternal and fetal outcomes [1]
The aim of this study is to estimate the prevalence of pre-gestational smoking, the prevalence of smoking during pregnancy and factors associated with smoking cessation up to the 20th gestational week
Higher prevalence rates for pre-gestational and gestational smoking were found in women living in the South and Southeast of Brazil, who received birth care in public and mixed hospitals, with black skin color, without paid work and not living with a partner
Summary
Smoking during pregnancy is a major public health problem, associated with various adverse maternal and fetal outcomes [1]. Based on an extensive review including 295 studies that reported national data from 1985 to 2016, the global prevalence of smoking during pregnancy was estimated. A study based on available data from population surveys estimated that between 1989 and 2015, smoking during pregnancy caused 410,065 deaths due to low birth weight, 358,821 due to prematurity, and 25,070 due to placenta previa or placental abruption [19]. The decision of quitting smoking for health reasons is usually threatened by the relaxing effects of nicotine in a context of heavy dependence of this drug and a critical moment of transformation and stress such as pregnancy [22]. The aim of this study is to estimate the prevalence of pre-gestational smoking, the prevalence of smoking during pregnancy and factors associated with smoking cessation up to the 20th gestational week
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