Abstract
The aims of the study were to describe changes in smoking habits and evaluate secular trends among all Norwegian pregnant women during the period 1999-2004. We wanted to investigate whether there was a general decline in smoking habits among pregnant women. We also wanted to identify population subgroups with diverging trends. The Medical Birth Registry of Norway (MBR) has national coverage of all births of 16 or more gestational weeks. Since 1999, women have been asked about tobacco smoking at the beginning and at the end of pregnancy. We included records from 304,905 women giving birth in the period January 1999 through April 2004. Women born outside Norway were handled separately. The selection left a dataset containing 259,573 Norwegian-born women. We obtained information on smoking habits from 86% at the end of pregnancy. Among those, the daily smoking prevalence was reduced from 17.3% in 1999-2001 to 13.2% in 2002-2004. Higher smoking prevalence was found among multiparous (3+), teenage mothers, single women, and women with low educational level. From 1999 to 2004, a substantial decline in smoking prevalence among Norwegian pregnant women was identified in all subgroups. However, an increasing social polarisation with regard to education and smoking habits was observed in the study period. In order to reduce the smoking-related risks for unsuccessful pregnancy outcome, special attention should be paid to smoking habits among multiparous, teenage women, single women and women with low education.
Highlights
Tobacco is a legal consumer product that might kill its users even when used as intended by manufacturers,[1] and no level of use during pregnancy is considered safe
For the association between birth weight and later smoking habits we found that women born at term with low birth weight (
Using a subsample of nearly 3,000 women in The Norwegian Mother and Child Cohort Study with maternal plasma cotinine measurements, we found that selfreported tobacco status in pregnancy had a sensitivity of 82% and specificity of 99%
Summary
Tobacco is a legal consumer product that might kill its users even when used as intended by manufacturers,[1] and no level of use during pregnancy is considered safe. Methods: We studied associations between birthweight of women (n = 247 704) born in 1967–1995 and smoking habits at the end of their pregnancy 13–42 years later in a prospective, population-based cohort study from The Medical Birth Registry of Norway. Methods: Data from the population-based Medical Birth Registry of Norway was used to evaluate self-reported smoking at the beginning and end of two successive pregnancies among 118 355 Nordic women giving birth 1999–2014. Smoking women without SGA in first pregnancy, had a 2.7-fold increased risk of SGA in second pregnancy (95% CI 2.5, 3.0). Conclusions: Smoking throughout two successive pregnancies was associated with the greatest increased SGA risk compared with non-smokers, while cessation before or during the second pregnancy reduced this risk. Women who smoked in the first pregnancy without experiencing SGA are not protected against SGA in second pregnancy if they continue smoking
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