Prevalence Of Maternal Smoking Research Articles

Maternal Smoking Prevalence in Brazil in 2013 and 2019: Not What We Expected When They Were Expecting!

Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. We examined changes between 2013 and 2019 in the relative differences in smoking prevalence rates between pregnant and nonpregnant women aged 18-49 years. We used data from a nationally representative health survey conducted in Brazil in 2013 and 2019. A generalized linear model with binomial family and logarithmic link function was used to estimate, for each year of analysis, the crude and adjusted (by age group, educational attainment, place of residence, and status of protection from passive smoking at home) relative differences. In 2013, the proportion point estimate of tobacco use among pregnant women was lower than that observed among nonpregnant women (4.7% vs. 9.6%). However, in 2019 proportion point estimates were virtually the same (8.5% vs. 8.4%). After adjustment for selected variables, in 2013, smoking prevalence among pregnant women was 42% (p-value ≤ .05) lower than that observed among nonpregnant women. On the other hand, in 2019, maternal smoking prevalence was 13% (p-value > .05) higher than that found among nonpregnant women. Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations pose serious threats to public health and likely contribute to increasing maternal smoking prevalence. The fact that women smoke in such an important phase of their and their unborn children's lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and prenatal tobacco prevention and cessation interventions as part of health professionals' routine consultation. The decline in smoking prevalence among nonpregnant women between 2013 and 2019 was accompanied by an increase in maternal smoking prevalence. Monitoring tobacco use during pregnancy is critical for achieving the United Nations Sustainable Development Goals. Ongoing tobacco industry interference and the marketing of tobacco products to vulnerable populations in Brazil pose serious threats to public health. The fact that women smoke in such an important phase of their and their unborn children's lives reinforces the need to strengthen the implementation of concurrent tobacco control actions, including tobacco excise tax policy and primary healthcare professionals´ tobacco-related assistance during interaction with their patients.

Exposure to Smoking as a Predictor of ADHD Subtypes Among Children Within Saudi Arabia: An Observational Study.

To explore the prevalence of maternal smoking and SHS exposure during pregnancy among mothers of children diagnosed with ADHD and investigate exposure to smoking as a predictor of ADHD subtypes. A cross-sectional study was conducted from December 1, 2022, to February 28, 2023, using an online questionnaire. The study included 217 parents of children aged 4-17 years diagnosed with ADHD and without a family history of the disorder. Data on sociodemographic determinants, academic achievement, ADHD types, and maternal smoking habits during pregnancy were collected. Among the mothers surveyed, 6.4% reported smoking during pregnancy, while 41% were exposed to SHS. The study found a predominance of the combined subtype of ADHD among the children. Logistic regression analysis revealed that families with monthly income <10000 SR were 2.6 times more likely to have a child with inattentive or hyperactive ADHD (P < 0.03). Male gender was associated with a 46% reduced likelihood of these subtypes (P < 0.03). SHS smoking and active exposure to smoking during pregnancy did not show any significant effect on ADHD. The study found that child gender and family income were significantly associated with the distribution of ADHD subtypes, while maternal smoking and SHS exposure during pregnancy did not show a significant association. The high prevalence of SHS exposure emphasizes the need for increased public health awareness and interventions to promote smoke-free environments during pregnancy.

Genetic association of telomere length, obesity and tobacoo smoking with idiopathic pulmonary fibrosis risk

BackgroundDue to the inadequacy of published evidence, association of telomere length (TL), obesity and tobacco smoking with idiopathic pulmonary fibrosis (IPF) remains unclear. The aim of the study was to explore whether these exposures genetically affected the risk of the disease.MethodsGenetic variants from genome-wide association studies for TL, body mass index (BMI), body fat percentage (BFP) and tobacco smoking (including maternal smoking) were used as instrumental variables. Inverse-variance weighted were mainly adopted to determine the genetic association of these exposures with IPF. All analyses were conducted by R-software (version 3.6.1).ResultsFirstly, longer TL was associated with the decreased risk of IPF (OR = 0.475 per SD increase in TL, 95%CI = 0.336 ~ 0.670, P<0.001). Secondly, higher levels of BMI and BFP were related to the increased risk of the disease (OR = 1.425 per SD increase in BMI level, 95%CI = 1.114 ~ 1.823, P = 0.005; OR = 1.702 per SD increase in BFP level, 95%CI = 1.202 ~ 2.409, P = 0.003). Thirdly, maternal smoking was implicated in the increased risk of the disease (OR = 13.183 per SD increase in the prevalence of maternal smoking, 95%CI = 1.820 ~ 95.484, P = 0.011).ConclusionTL should be a genetic risk factor for IPF. Obesity and exposure to tobacco smoking as a fetus might also contribute to the development of this fibrotic diseases. These findings should be verified by future studies.

Inequality in smoking and related risk factors for smoking in expectant mothers - a nationwide Danish register-based study.

Foetuses exposed to smoking during pregnancy are disadvantaged due to numerous adverse obstetric outcomes. This study aimed to examine 1) inequality in maternal smoking between subgroups of pregnant women and 2) significant risk factors of maternal smoking. Data were collected from Danish registries. Trends in maternal smoking within each study period, T1 (2000-2002) and T2 (2014-2016), were investigated by Poisson regression calculating prevalence proportion ratios, and trends between study periods were studied by adding an interaction term. The significance of risk factors for maternal smoking (low age, low education, living alone and having a moderate/severe mental health condition) were studied by interaction analysis on the additive scale. The prevalence of maternal smoking decreased from 21% in 2000 to 7% in 2016. Decreases were found in all subgroups of maternal age, cohabitation status, educational level and mental health condition. However, large differences in smoking prevalence between subgroups were found, and inequality in maternal smoking increased from 2000 to 2016. The probability of maternal smoking increased with the addition of risk factors, and positive additive interactions were found for almost all combinations of multiple risk factors. Our results provide knowledge on risk factors and increasing levels of inequality in maternal smoking which points to a need for targeted interventions in relation to maternal smoking for subgroups of pregnant women in future smoking cessation programmes and in antenatal care.

Secular trends of socio-demographic and lifestyle characteristics among delivering women in Arctic Russia, 1973-2017

ABSTRACT The aim of this study was to describe temporal trends in socio-demographic and lifestyle characteristics among delivering women in two Northern provinces of Russia from 1973 to 2017. Totally 161,730 births were registered in three birth registries. Changes in the distribution of maternal age, education, marital status, smoking during pregnancy were studied using Pearson’s chi-squared tests and one-way ANOVA. The logistic regression models were used to assess factors, contributing to the variations in the prevalence of maternal smoking. The mean age of primiparous mothers increased from 22.1 years in 1973–1980 to 25.4 years in 2012–2017 (p < 0.001). The proportion of primiparous mothers with higher education increased from 26.2% in 2006 to 38.3% in 2017 (p < 0.001). The proportion of cohabiting primiparous women increased from 5.0% to 15.2% over the study period (p < 0.001). The proportion of mothers smoking during pregnancy decreased from 18.9% in 2006–2011 to 14.8% in 2012–2017 (p < 0.001). Downward in the prevalence of smoking was revealed in 2012–2017 compared to 2006–2011 (OR = 137.76; 95%CI:71.62–264.96, OR = 183.74; 95%CI:95.52–353.41, respectively). Over the past decades, women postpone childbearing until receiving higher education, continue living in cohabitation during pregnancy and smoke less.

Early Life Determinants of Vascular Structure in Fetuses, Infants, Children, and Adolescents: A Systematic Review and Meta-Analysis

To investigate the association between early life exposures during the first 1000days (conception to age 24months) and aortic intima-media thickness (aIMT), an early indicator of cardiovascular disease (CVD) risk, in youths. The MEDLINE, Embase, Scopus, CINAHL, and Allied and Complementary Medicine databases were searched from inception to July 2021. Eligibility criteria included observational controlled studies in youths aged <20years with risk factors/exposures during the first 1000days and aIMT measurements (unadjusted mean±SD). Outcome data were pooled using a random-effects meta-analysis. Meta-regression was used to investigate confounders. A total of 8657 articles were identified, of which 34 were included in our meta-analysis. The age of participants ranged from 22.9weeks gestation in utero to 10.9years. In the meta-analysis (n=1220 cases, n=1997 controls), the following factors were associated with greater aIMT: small for gestational age (SGA) status (14 studies, mean difference, 0.082mm; 95% CI, 0.051-0.112; P<.001; I2=97%), intrauterine growth restriction (6 studies; mean difference, 0.198mm, 95% CI, 0.088-0.309; P<.001; I2=97%), preeclampsia (2 studies; mean difference, 0.038mm; 95% CI, 0.024-0.051; P<.001; I2=38%), and large for gestational age (LGA) status (3 studies; mean difference, 0.089mm; 95% CI, 0.043-0.0136; P<.001; I2=93%). In meta-regression, older age (P<.001), higher prevalence of maternal smoking (P=.04), and SGA (P<.001) were associated with greater difference in aIMT in preterm participants compared with controls. Limitations included the high heterogeneity present in most meta-analyses and the scope of our meta-regression. Adverse early life exposures are associated with greater aIMT in youths, consistent with an increased risk for CVD later in life. Further research is needed to determine whether intervention and preventive strategies deliver clinical benefits to improve future cardiovascular health.

Trajectories of asthma symptom presenting as wheezing and their associations with family environmental factors among children in Australia: evidence from a national birth cohort study

ObjectivesAsthma is one of the greatest health burdens, yet contributors to asthma symptom trajectories are understudied in Australian children. We aimed to assess the trajectories of asthma symptom and their...

Implications for comorbidities, maternal smoking during pregnancy, and inflammation in current smokers

• Smokers presented higher prevalence of major depressive disorder and alcohol problems. • Smokers showed lower levels of leptin, higher levels of HDL-c and higher castelli indexes. • Maternal smoking during pregnancy was significantly more frequent among smokers. • Heavy smokers had higher levels of sTNFR1 than light-smokers. • Smokers showed higher levels of TNF-alfa and its receptors (sTNFR1 and 2) than non-smokers. Evaluate comorbidities, childhood abuse, and inflammation in current heavy-smokers compared to light-smokers and never-smokers. Current-Smokers ( n = 129) and never-smokers ( n = 85) were screened for the use of alcohol, tobacco, and other substances, and assessed for nicotine dependence and childhood trauma. Tumor necrosis factor alpha (TNF-α) and its receptors (sTNFR1 and sTNFR2), leptin, lipid hydroperoxide, and lipid profile biomarkers were measured after overnight fasting. Current-smokers presented higher prevalence of major depressive disorder (PR = 1.79, CI 95% [1.36–2.37], p <0.001), alcohol problems (PR = 1.31, CI 95% [1.05–1.32], p <0.001), cancer disease (PR = 1.57, CI 95% [1.06–2.47], p <0.001), and maternal smoking during pregnancy (PR = 1.48, CI 95% [1.14–1.91], p <0.001) in comparison with never-smokers. Current-smokers showed significantly lower levels of leptin ( p <0.001) and high-density lipoprotein cholesterol levels ( p <0.001), higher Castelli risk indexes I and II ( ps <0.001), and lipid hydroperoxide levels ( p <0.001) than never-smokers. Among current-smokers, heavy-smokers also presented higher levels of sTNFR1 than light-smokers ( p = 0.04). This is an exploratory cross-sectional study which did not allow us to delineate associations or causality of the events. The group of never-smokers presented significantly more years of education than current-smokers. The age of our sample ranged from 18 to 65 years-old, which do not allow the generalization to older or younger population. Finally, maternal smoking was collected retrospectively based on participants’ reports. Our study suggests an opportunity to identify current-smokers who had co-occurring clinical and psychiatric comorbidities and childhood trauma, and to offer them the opportunity of personalized treatments.

Smoking, Vaping, While Breastfeeding in the Era of COVID-19

Breastfeeding MedicineAhead of Print EditorialFree AccessSmoking, Vaping, While Breastfeeding in the Era of COVID-19Arthur I. EidelmanArthur I. Eidelman—Arthur I. Eidelman, MD, FABM, Editor in Chief, Breastfeeding Medicine Search for more papers by this authorPublished Online:28 Sep 2021https://doi.org/10.1089/bfm.2021.29192.aieAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail This month's issue of Breastfeeding Medicine includes a most balanced summary by our regular esteemed contributor Phil Anderson regarding the dilemma of proscribing smoking cessation/reduction products to breastfeeding mothers. Estimates as to maternal postpartum smoking prevalence vary, but surveys of high-income countries report a rate of ∼10%.1 These levels do not include data from recent reports regarding the additional exposure to nicotine that results from the increased prevalence of >7% of e-cigarette use (vaping), particularly by teenagers and young adults.2 Unfortunately, specific data as to prevalence in nursing mothers are, to date, lacking.Smoking by breastfeeding mothers has been associated with reduced volume of breast milk, earlier weaning, and an increased risk for sudden infant death syndrome.3 Tobacco smoking itself has a negative effect on the macrocomposition of the milk as it decreases lipids, protein, and caloric content. In addition, smoking results in decreased antioxidant property of human milk. These negative effects have been attributed primarily to the pharmacologic effect of nicotine, but also to the effect of other toxic substances such as tar, lead, and cadmium. As such, use of e-cigarettes that results in less exposure of the mother to these toxic substances might well be preferable. Unfortunately data as to such a therapeutic trial are unavailable. However, one should note the recent disturbing report from McBride4 that noted an association of e-cigarette use during pregnancy and a decreased frequency of breastfeeding postpartum.In these days of the COVID-19 pandemic, the inevitable question is does smoking increase the risk of severe disease in those infected with the virus. Given the fact that smoking is an established risk factor for a myriad of pulmonary diseases, one would expect a clear-cut association with COVID-19 severity. Surprisingly, to date the population epidemiological surveys are inconclusive, with reports such as that of Karanasos5 who reported that smoking was associated with higher odds of severe disease, whereas another meta-analysis by Farsalinos,6 using a different methodology reported that in patients who were smokers, there was no increased risk for COVID-19 severe disease and or mortality.This seeming counter-intuitive finding may be supported by our understanding more fully the function of the nicotinic acetyl choline receptors who when stimulated (by nicotine) facilitate a pathway that modulates the activity of the immune system. Thus, it is postulated that exposure to nicotine (paradoxically) minimizes an uncontrolled immune response that is triggered by the COVID-19 virus, a response that may well be a major factor (mechanism) in inducing a severe morbidity/mortality outcome.These preliminary data surely do not legitimate the use of nicotine as a therapeutic modality in the treatment of COVID-19. In fact as Anderson details, the primary goal in the situation where a breastfeeding mother is also a smoker should be to maximize the continued and well-documented benefits of exclusive breastfeeding while minimizing the infant's exposure to the combined toxicity of smoking as much as possible. Thus, as he recommends the absolute goal should be to have the mother stop smoking and provide cautiously and judiciously an alternative less toxic source of nicotine such as patches and e-cigarettes for the mother to proceed with a weaning process. It is clear that no smoking cessation therapy appears to be ideal for nursing mothers as the various drugs have a theoretical potential toxicity for the breastfed infant or they have not been adequately studied for efficacy. But as Anderson so simply puts it, smoking cessation products are preferable to continued smoking during breastfeeding. Surely in these days of COVID-19.

A single-center, prospective, observational study on maternal smoking during pregnancy in Greece: The HELENA study.

INTRODUCTIONThe unequivocal association between exposure to smoke and numerous complications of pregnancy, demonstrated in the last decades, has led to a significant decrease of smoking rates in pregnancy. The aim of the present study was to determine the prevalence of maternal smoking and to elucidate factors predisposing to it among pregnant women in Athens, Greece.METHODSA population of 1700 pregnant women (mean age: 31.2±5.5 years) who visited consecutively the Cardiology Department of Helena Venizelou Maternity Hospital in Athens, Greece, between September 2016 and August 2017, was prospectively analyzed. Data regarding changes in the future mother’s smoking habit as well as different sociodemographic factors potentially related to these changes were recorded.RESULTSOf the 1700 participants, 704 (41.4%) were smokers, and of those 52.4% quit smoking after knowledge of their pregnancy status. The overall prevalence of smoking in pregnancy was 19.7%. Prevalence was higher in women who were aged <20 years (p=0.038), were multipara (p=0.032), had ≤12 years of education (p=0.044) and had a partner who was a smoker (p=0.047). Women aged ≤20 years were more likely to be persistent smokers at the beginning of pregnancy and demonstrated a higher prevalence of smoking during pregnancy (42.2% vs 19.7% in the overall study population).CONCLUSIONSOur data demonstrate that maternal smoking during pregnancy still remains a major public health issue in Greece with a prevalence higher than most other industrialized countries.

Smoking during pregnancy: changes and associated risk factors in Spain, 1980-2016.

Trends for maternal smoking rates have varied substantially across industrialized countries. The objective was to describe how the prevalence of maternal smoking evolved in Spain during 1980-2016. Data came from the Spanish Collaborative Study of Congenital Malformations. Our sample consisted of 40934 mothers of newborns with no congenital defects from hospitals all across Spain. We estimated change points in trend and the mean annual change in smoking prevalence using 'joinpoint' regression. Relevant potential factors (age, country of birth, education, parity, planned pregnancy and alcohol consumption) were examined using multivariate logistic regression. Maternal smoking prevalence in 1980 and 2016 were 14.3% (95% confidence interval [CI]: 11.9-17.0) and 20.4% (95% CI: 15.9-25.8). We identified four periods with distinct trends: a sharp increase during the 80s, a plateau during the 90s, a decrease starting in 2000 and a slowdown of such decrease from 2009 on. Smoking was significantly higher among young women, Spain-born, with low education, unplanned pregnancy, and alcohol consumption. Currently in Spain maternal smoking remains very high. Tobacco consumption trend showed an increase during the 80s, a plateau during the 90s, and a reduction in the 2000s. Several sociodemographic and behavioural factors were associated to greater likelihood of smoking.

Maternal smoking during pregnancy: Trends and determinants in the conception to community study.

Despite earlier declines, maternal smoking during pregnancy continues to be a public health problem. We examined trends and factors associated with maternal smoking during and between pregnancy over six years. Participants were 27 532 pregnant women in Tasmanian public hospitals whose smoking status was gathered by midwives during perinatal care between July 2008 and June 2014. Generalized linear modeling was used to examine the trends in prevalence of maternal smoking over time and factors associated with change in smoking status both within and between pregnancies. Smoking during pregnancy decreased from 25.9% in 2008 to 16.4% in 2014 (57.9% decline). Multivariable regression analysis suggested that maternal alcohol consumption during pregnancy, living in a highly socioeconomically disadvantaged area, and being an Aboriginal or Torres Strait Islander significantly increased the risk of maternal smoking during pregnancy. Being older, married, or in a de facto relationship, and intending to breastfeed were associated with reduced risk of smoking during pregnancy. Between index (first birth recorded in data set) and last pregnancy, 35.1% of smokers quit, but 5.1% of nonsmokers started smoking. Only 8.1% of mothers who smoked during the first half of pregnancy quit by the second half. Maternal smoking during pregnancy is decreasing. To sustain the decline, preventive efforts must address the role of social determinants of health (eg, mothers who drink alcohol, live in highly disadvantaged areas, are younger and single) among women who smoke during pregnancy.

Association between neighborhood socioeconomic status, tobacco store density and smoking status in pregnant women in an urban area

Smoking during pregnancy can lead to serious health consequences. Given such health risks, an understanding of factors that influence maternal smoking behaviors during pregnancy is critical. The objective of this study is to assess the relationship between tobacco store density, neighborhood socioeconomic status, and neighborhood rates of maternal smoking during pregnancy. Fifty-five community areas in Baltimore City were summarized using data from the Neighborhood Health Profiles. Associations between tobacco store density and smoking while pregnant in a community were determined using Moran's I and spatial regression analyses to account for autocorrelation. The fully adjusted model took into account the following community-level socioeconomic variables as covariates: neighborhood median income, percentage of those living in poverty, percentage of uninsured, and percentage of persons with at least a college degree. In regards to the findings, the percentage of women by community area who identified as actively smoking while pregnant was 10.4% ± 5.8%. The tobacco store density was 21.0 ± 12.7 per 10,000 persons (range 0.0–49.1 tobacco store density per 10,000 persons). In the adjusted model, an increase in density of 1 tobacco store per 10,000 persons was associated with a 10% increase in women who reported smoking during pregnancy (β = 0.10, p = 0.04). In conclusion, tobacco store density and neighborhood socioeconomic factors were associated with prevalence of maternal smoking while pregnant. These findings support the need to further assess and develop interventions to reduce the impact of tobacco store density on smoking behaviors and health risks in communities.

Using a cross-cohort comparison design to test the role of maternal smoking in pregnancy in child mental health and learning: evidence from two UK cohorts born four decades apart.

BackgroundMaternal smoking in pregnancy is associated with low birth weight (LBW), child conduct problems, hyperactivity and lower cognitive attainment, but associations may reflect measured and unmeasured confounding. Cross-cohort designs can aid causal inference through comparison of associations across populations with different confounding structures. We compared associations between maternal smoking in pregnancy and child conduct and hyperactivity problems, cognition and LBW across two cohorts born four decades apart.MethodsTwo national UK cohorts born in 1958 (n = 12 415) and 2000/01 (n = 11 800) were compared. Maternal smoking in pregnancy and child birth weight was assessed at or shortly after birth. Parents rated children’s conduct problems and hyperactivity, and children completed standardized tests of reading and mathematics.ResultsMaternal smoking in pregnancy was less common and more strongly associated with social disadvantage in 2000/01 compared with 1958 (interactions P < 0.001). Maternal smoking in pregnancy was robustly and equivalently associated with infant LBW in both cohorts [interactions: boys odds ratio (OR) = 1.01 (0.89, 1.16), P = 0.838; girls OR = 1.01 (0.91, 1.17), P = 0.633]. Maternal smoking was more strongly associated with conduct problems, hyperactivity and reading in the 2000/01 cohort (interactions P < 0.001).ConclusionsMarked cross-cohort change in associations between maternal smoking and child conduct problems, hyperactivity and reading highlights the likely role of confounding factors. In contrast, association with LBW was unaffected by change in prevalence of maternal smoking and patterns of confounding. The study highlights the utility of cross-cohort designs in helping triangulate conclusions about the role of putative causal risk factors in observational epidemiology.

Household environmental tobacco smoke exposure in healthy young children in Hong Kong: Prevalence and risk factors.

BackgroundEnvironmental tobacco smoke (ETS) exposure attributable respiratory illness burden is huge in paediatric population. Understanding the epidemiology of ETS exposure is important to guide health promotion planning. Therefore, we designed this study to determine the prevalence of household ETS exposure in healthy young children under 2 years of age in Hong Kong, and to explore risk factors associated with the exposure. Our secondary goal was to characterise children’s exposure profile to maternal smoking.MethodsA secondary analysis was performed based on the data collected from our 2013–2014 territory-wide cross-sectional pneumococcal carriage surveillance study, with a sample size of 1541. We conducted descriptive analysis for exposure prevalence, univariate and multivariate analysis for identification of risk factors.Results1541 children (mean age: 11.2 ± 6.4 months, male: 50.7%) were included in the analysis. The overall prevalence of current household ETS exposure was 31.5%, prevalence of prenatal and postnatal maternal smoking was 3.5% and 1.6% respectively. Independent factors associated with children’s ETS exposure were: never breastfed (AOR: 1.48, 95% CI: 1.13–1.93, p = 0.004); prenatal maternal smoking (AOR: 7.46, 95% CI: 2.73–20.39, p< 0.001); overcrowding of household living place (AOR: 3.17, 95% CI: 2.02–4.96, P< 0.001); lower household income (AOR: 1.34, 95% CI: 1.04–1.72, p = 0.02). Interestingly, children residing in Kowloon (AOR: 1.66, 95% CI: 1.19–2.33, p = 0.003) and New Territories West (AOR: 1.54, 95% CI: 1.11–2.15, p = 0.01) were associated with exposure compared with children residing in Hong Kong Island.ConclusionExposure to household ETS is prevalent among Hong Kong young children, particularly in children with maternal unfavourable behaviour and lower socioeconomic status. The identified risk factors should be considered while tobacco control interventions and legislations are planned.

Impact of Maternal Smoking on the Onset of Breastfeeding versus Formula Feeding: A Cross-Sectional Study.

This study sought to estimate the prevalence of maternal smoking and its association with exclusive breastfeeding vs. formula feeding. A cross-sectional study was performed on postpartum women at a public hospital in Spain, between January and August 2018. The main variables studied were their age, level of study, smoking habits, and chosen mode of infant feeding. In total, 948 postpartum women were included. Of these, 12.45% were smokers who smoked a mean of 7.23 cigarettes/day. Among the group of smokers, the probability of feeding the newborns with formula milk was multiplied by 2.32 ([95%CI 1.50–3.58] p < 0.001). When stratifying tobacco use into mild, moderate and severe, we found a statistically significant dose–response pattern. These associations and their statistical significance were maintained when adjusting by age and level of study. In conclusion, in the group of postpartum mothers who smoked, the probability of feeding the newborns with formula milk doubled. Our data highlight the need to improve health education programs in women of childbearing age, especially during pregnancy.

Sudden infant death syndrome (SIDS) and the routine otoacoustic emission infant hearing screening test: an epidemiological retrospective case–control study

ObjectivesTo investigate whether decreased otoacoustic emission (OAE) signal recordings in the right ear are associated with an increased risk of sudden infant death syndrome (SIDS) and to monitor any temporal...

Prevalence and predictors of maternal smoking prior to and during pregnancy in a regional Danish population: a cross-sectional study

BackgroundMaternal smoking is still a major public health problem posing the risk of several negative health outcomes for both the pregnant woman and her offspring. The prevalence of maternal smoking in Denmark and other high-income countries has decreased continuously since the 1980s, and a prevalence below 10% of women who continue to smoke during pregnancy has been reported in studies after 2010. Previous studies have shown that low socioeconomic status is associated with maternal smoking. Information from the Danish Birth Register about maternal smoking shows that the prevalence of women who report to smoke in pregnancy has decreased continuously with 23.3% who reported ever smoking in pregnancy in 2000, 12.9% in 2010 and 9.0% in 2017. The aim of this study was to estimate the prevalence of maternal smoking at the time of conception and at 20 weeks of gestation in a regional Danish population, to describe differences in maternal characteristics among smokers, quitters and never-smokers, and to estimate predictors of smoking at the time of conception.MethodsA cross-sectional study was conducted among pregnant women receiving antenatal care at the Department of Obstetrics, Zealand University Hospital, Denmark from August 2015 to March 2016 (n = 566). The main outcome was smoking at the time of conception and at 20 weeks of gestation. The questionnaire also collected information about maternal, health-related and sociodemographic characteristics. Descriptive analysis was conducted, and multivariate logistic regression analysis was used to assess the potential associated predictors (adjusted odds ratio).ResultsThe prevalence of self-reported smoking at the time of conception was 16% (n = 90) and 6% smoked at 20 weeks of gestation (n = 35), as 61% of smokers quit smoking during early pregnancy. Multiple logistic regression analysis showed that significant predictors for smoking at conception were the socioeconomic factors; ≤12 years of education, shift work and being unemployed.ConclusionThe prevalence of self-reported maternal smoking in this regional Danish population of pregnant women is lower than seen in previous studies. However, predictors for smoking at the time of conception remain to be factors of low socioeconomic status confirming a social inequality in maternal smoking. Women at risk of smoking during pregnancy must be identified in early pregnancy or even before pregnancy and be offered interventions to help them quit smoking.

Tobacco use during pregnancy among native and migrant women in Portugal. Results from the Bambino study

Introduction Tobacco use is a major modifiable risk factor of adverse maternal and fetal health outcomes. Being a migrant has been associated with lower risk of smoking during pregnancy. However, it remains a matter of debate whether such association could be explained by other sociodemographic characteristics or whether such effect remains or increases according to the length of stay in the host country. This study examined the differences in maternal smoking prevalence between native, long-term and recent migrant women in Portugal. Methods This study was derived from baMBINO, a national project grounded on 32 public maternity units in mainland Portugal aiming to investigate the differences in perinatal healthcare and outcomes among migrant and native women. Recruitment took place during admission for delivery, inviting both native and foreign-born women. Participants included in this analysis (n = 1107) were classified according to their country of birth and length of stay in Portugal into: native (Portuguese-born), recent migrant (foreign-born women who spent 10 years or less in Portugal), and long-term migrants (foreign-born women who spent more than 10 years in Portugal). Logistic regression model was fitted to estimate the association between the aforementioned migration statuses and having or not smoked tobacco during pregnancy, taking into account women's age, parity, marital status, level of education, family income, country of origin of women's parents and gestational age at the first prenatal care visit. Adjusted odds ratio (OR) and respective 95% confidence interval (95% CI) were obtained. Results A little over half of the study participants were foreign-born and almost 60% of those were recent migrants. Tobacco smoking during pregnancy was evidently more prevalent among native women than among long-term or recent migrant women (14% vs. 8% and 4% respectively; P Conclusion Results of this study demonstrated significant disparities in the prevalence of maternal smoking during pregnancy according to the women's place of birth and duration of stay in Portugal. Native-born women had a higher risk of smoking during pregnancy than foreign-born women. The increase in the duration of stay in the host country seemed to have a negative effect on maternal smoking of migrants in Portugal. Smoking cessation health strategies in pregnant women in Portugal need to be improved by taking into account the mentioned variations in smoking behaviors.

Development of Social and Demographic Differences in Maternal Smoking Between 1999 and 2014 in Norway.

The Medical Birth Registry of Norway provides national coverage of all births in Norway. In this study trends of smoking at the beginning of pregnancy and the variation of these trends across different sociodemographic groups are analyzed. This knowledge is important for planning interventions both in the general population and specifically among pregnant women. All births registered in Medical Birth Registry of Norway 1999-2014 with information on mothers' smoking status were included in the overall analyses of the smoking trends (806 298). Records from 210 268 births in two time periods 1999-2000 and 2013-2014 were selected, and for the multivariate analyses we used general linear models to provide adjusted risk ratios. The prevalence of maternal smoking at the beginning of pregnancy decreased from 25% to 8% over the 15-year period. Mothers with low, medium, and high education, respectively, had a 46% (RR 0.54, CI 0.52-0.55), 62% (RR 0.38, CI 0.37-0.40), and 80% (RR 0.20, CI 0.19-0.22) reduction in maternal smoking between the two time periods. Similarly, the decline in smoking was greater for mothers who were married or living together (64%; RR 0.36, CI 0.35-0.37) than for single mothers (39%; RR 0.61, CI 0.58-0.64). Immigrants had a lower smoking prevalence than Norwegians in the entire period 1999-2014. The prevalence of smoking during pregnancy in Norway decreased in all population groups, but the relative differences between the educational groups increased from 1999-2000 to 2013-2014. This is a public health concern and a strong contributor to health disparities. Women with low and medium education level and single mothers had the highest smoking prevalence and the lowest decline over the two time periods. These groups constitute 45% of our study population, the relatively high maternal smoking in these groups continues to be of public health concern for maternal and child health.