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Wójcik M, Alvarez-Pitti J, Kozioł-Kozakowska A, Brzeziński M, Gabbianelli R, Herceg-Čavrak V, Wühl E, Lucas I, Radovanović D, Melk A, González Lopez-Valcarcel B, Fernández-Aranda F, Mazur A, Lurbe E, Borghi C, Drożdż D. Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview. Front Cardiovasc Med 2023; 10:1268364. [PMID: 38054100 PMCID: PMC10694215 DOI: 10.3389/fcvm.2023.1268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Agnieszka Kozioł-Kozakowska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Kraków, Poland
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ignacio Lucas
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hannover, Germany
| | - Beatriz González Lopez-Valcarcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dorota Drożdż
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
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Hamilton WN, Masud N, Kouambo C, Tarasenko YN. Perinatal Smoking and E-cigarette Use and Their Relationship with Breastfeeding: PRAMS 2015-2020. Breastfeed Med 2023; 18:855-863. [PMID: 37902988 DOI: 10.1089/bfm.2023.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Introduction: Electronic cigarette (e-cigarette) use poses concerns among women of child-bearing age. We examined prevalence of breastfeeding among the U.S. women and characteristics associated with exclusive use of cigarettes, e-cigarettes, or both products. Materials and Methods: Our study is based on pooled cross-sectional data from 2015-2020 Pregnancy Risk Assessment Monitoring System. Two outcomes were breastfeeding initiation and breastfeeding duration for over 6 months, as recommended by the American Academy of Pediatrics (AAP). Binary logistic regressions were used to examine associations between each outcome and type of tobacco products unadjusted and adjusted for potential confounders, with post hoc estimation of average adjusted predictions, marginal effects, and contrasts of margins in Stata. Results: Adjusted prevalence of breastfeeding initiation was significantly higher in women who used e-cigarettes (86.15%) than conventional cigarettes (72.16%) or both products (79.54%). Similarly, a significantly higher percentage of women who used e-cigarettes continued breastfeeding after 6 months (49.20%) than women who smoked conventional cigarettes (31.30%) or both products (29.83%). Among women who neither smoked nor used e-cigarettes, 85.29% initiated breastfeeding and 57.20% continued breastfeeding as recommended by the AAP. Conclusion: Likelihood of breastfeeding initiation and continuation in women using e-cigarettes was comparable to those who neither smoked nor used e-cigarettes. Future research needs to elucidate differences in breastfeeding by sociodemographic and health-related characteristics of women who smoke or use both products compared to those who use e-cigarettes. Understanding women's motivation behind use of a particular tobacco product is also important, so mothers who smoke e-cigarettes are not incorrectly perceived as safer users and excluded from tobacco cessation interventions.
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Affiliation(s)
- Whitney N Hamilton
- Department of Health Services Administration, Middle Georgia State University, Macon, Georgia, USA
| | - Nazish Masud
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Cyrille Kouambo
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Yelena N Tarasenko
- Department of Biostatistics Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
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Souza LL, Rossetti CL, Peixoto TC, Manhães AC, de Moura EG, Lisboa PC. Neonatal nicotine exposure affects adult rat hepatic pathways involved in endoplasmic reticulum stress and macroautophagy in a sex-dependent manner. J Dev Orig Health Dis 2023; 14:639-647. [PMID: 38037831 DOI: 10.1017/s2040174423000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) involves changes in hepatic pathways, as lipogenesis, oxidative stress, endoplasmic reticulum (ER) stress, and macroautophagy. Maternal nicotine exposure exclusively during lactation leads to fatty liver (steatosis) only in the adult male offspring, not in females. Therefore, our hypothesis is that neonatal exposure to nicotine sex-dependently affects the signaling pathways involved in hepatic homeostasis of the offspring, explaining the hepatic lipid accumulation phenotype only in males. For this, between postnatal days 2 and 16, Wistar rat dams were implanted with osmotic minipumps, which released nicotine (NIC; 6 mg/Kg/day) or vehicle. The livers of offspring were evaluated at postnatal day 180. Only the male offspring that had been exposed to nicotine neonatally showed increased protein expression of markers of unfolded protein response (UPR), highlighting the presence of ER stress, as well as disruption of the activation of the macroautophagy repair pathway. These animals also had increased expression of diacylglycerol O-acyltransferase 1 and 4-hydroxynonenal, suggesting increased triglyceride esterification and oxidative stress. These parameters were not altered in the female offspring that had been neonatally exposed to nicotine, however they exhibited increased phospho adenosine monophosphate-activated protein kinase pAMPK expression, possibly as a protective mechanism. Thus, the disturbance in the hepatic homeostasis by UPR, macroautophagy, and oxidative stress modifications seem to be the molecular mechanisms underlying the liver steatosis in the adult male offspring of the nicotine-programming model. This highlights the importance of maternal smoking cessation during breastfeeding to decrease the risk of NAFLD development, especially in males.
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Affiliation(s)
- Luana Lopes Souza
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Camila Lüdke Rossetti
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thamara Cherem Peixoto
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alex Christian Manhães
- Laboratory of Neurophysiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Egberto Gaspar de Moura
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patrícia Cristina Lisboa
- Laboratory of Endocrine Physiology, Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Bonello K, Figoni H, Blanchard E, Vignier N, Avenin G, Melchior M, Cadwallader JS, Chastang J, Ibanez G. Prevalence of smoking during pregnancy and associated social inequalities in developed countries over the 1995-2020 period: A systematic review. Paediatr Perinat Epidemiol 2023; 37:555-565. [PMID: 37427978 DOI: 10.1111/ppe.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Smoking during pregnancy (SDP) is an important source of preventable morbidity and mortality for both mother and child. OBJECTIVES The aim of this study was to describe changes in the prevalence of SDP over the last 25 years in developed countries (Human Development Index >0.8 in 2020) and associated social inequalities. DATA SOURCES A systematic review was conducted based on a search in PubMed, Embase and PsycInfo databases and government sources. STUDY SELECTION AND DATA EXTRACTION Published studies between January 1995 and March 2020, for which the primary outcome was to assess the national prevalence of SDP and the secondary outcome was to describe related socio-economic data were included in the analysis. The selected articles had to be written in English, Spanish, French or Italian. SYNTHESIS The articles were selected after successive reading of the titles, abstracts and full-length text. An independent double reading with intervention of a third reader in case of disagreement allowed including 35 articles from 14 countries in the analysis. RESULTS The prevalence of SDP differed across the countries studied despite comparable levels of development. After 2015, the prevalence of SDP ranged between 4.2% in Sweden and 16.6% in France. It was associated with socio-economic factors. The prevalence of SDP slowly decreased over time, but this overall trend masked inequalities within populations. In Canada, France and the United States, the prevalence decreased more rapidly in women of higher socio-economic status, and inequalities in maternal smoking were more marked in these countries. In the other countries, inequalities tended to decrease but remained significant. CONCLUSIONS During pregnancy, that is a period described as a window of opportunity, smoking and social vulnerability factors need to be detected to implement targeted prevention strategies aiming at reducing related social inequalities.
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Affiliation(s)
- Kim Bonello
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Hugo Figoni
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Estelle Blanchard
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Nicolas Vignier
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Guillaume Avenin
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
| | - Maria Melchior
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Jean-Sébastien Cadwallader
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Julie Chastang
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Gladys Ibanez
- Department of General Practice, School of Medicine, Sorbonne Université, Paris, France
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
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Popoola A, Panday J, Taneja S, Greyson D, McDonald SD, Patel T, Darling E, Vanstone M. Pregnant and lactating people's strategies to mitigate the risk of cannabis consumption. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231202406. [PMID: 37776037 PMCID: PMC10541750 DOI: 10.1177/17455057231202406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Multiple studies have demonstrated that pregnant and lactating people who use cannabis perceive a variety of benefits from that use, offering some explanation of why rates of use continue to increase. OBJECTIVES The aim of this study was to explore pregnant and lactating people's perceptions of the risks of cannabis use and understand what steps, if any, they take to mitigate these risks. DESIGN Qualitative description. METHODS We analyzed semi-structured interviews with 52 Canadians who made the decision to start, stop, or continue using cannabis during pregnancy or lactation between 2019 and 2021. Data collection iterated with analysis. We used a conventional (inductive) approach to content analysis. RESULTS Perception of risk was found to be an essential component of decision-making about cannabis use. We identified a cycle of "risk identification," "management," and "observation" of effects. First, the pregnant or lactating person assesses the risks and weighs them against the perceived benefits of cannabis use. Second, they take action to minimize risks, with some choosing abstinence. Others, often those who were using cannabis to manage symptoms, continued cannabis use but devised a variety of other risk mitigation strategies such as, decreasing the amount or frequency of their use, changing the form of cannabis, and strategically timing their use with caregiving responsibilities. The final stage of the cycle involves seeking information about whether or not the initial perceived risk has manifested after implementing mitigation strategies, through observations and clinical information about the pregnancy or child. CONCLUSION Participants consistently engaged in deliberation about the risks and benefits associated with their perinatal cannabis use. Nearly all implemented strategies intended to minimize risk. Our results highlight the need for more research to inform clear public health messaging about risk mitigation to minimize the potential harms of perinatal cannabis use. This work informs clinicians about patient-perceived risks and mitigation strategies which could in turn help inform shared decision-making conversations.
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Affiliation(s)
- Anuoluwa Popoola
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Janelle Panday
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Shipra Taneja
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Devon Greyson
- Department of Communication, University of Massachusetts Amherst, Amherst, MA, USA
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sarah D. McDonald
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Radiology and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - Tejal Patel
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Elizabeth Darling
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Peprah P, Agyemang-Duah W, Gyamfi N, Asare BYA, Boateng D, Appiah JO, Adu C. Cigarette smoking during breastfeeding in Papua New Guinea: Prevalence and demographic and socio-economic predictors. PLoS One 2022; 17:e0278373. [PMID: 36454927 PMCID: PMC9714934 DOI: 10.1371/journal.pone.0278373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cigarette smoking during breastfeeding is reported to contribute to significant changes in the composition of breast milk not only by reducing its protective features but also affecting infants' response to breastfeeding and breast milk. However, studies on the prevalence of cigarette smoking and associated factors during breastfeeding are limited in Papua New Guinea (PNG). This study estimates the prevalence of cigarette smoking and its association with demographic and economic factors among breastfeeding women in PNG. METHODS We used weighted survey data from the 2016-2018 PNG Demographic and Health Survey (PNGDHS). A weighted sample of 3,822 women who were breastfeeding during the survey were included in the study. The outcome variable in the present study is current cigarette smoking. A multiple logistic regression analysis was used to estimate the association between current cigarette smoking status and socio-demographic and economic variables of breastfeeding women. The regression analysis results were reported using adjusted odds ratios (aOR) with their respective 95% confidence intervals (CIs). RESULTS From the weighted sample, the prevalence of cigarette smoking among breastfeeding women was 21.9%; of which 60.8% smoked daily. The mean number of cigarettes smoked in the last 24 hours preceding the survey was 6.05(SD = 5.99). Multiple logistic regression analysis revealed that breastfeeding women who were from the Momase (aOR: 2.337, CI: 1.786-3.058, p<0.001) and Highlands (AOR: 1.589, CI: 1.213-2.082, p = 0.001), had no religious affiliation (aOR: 3.665, CI: 1.235-10.877, p = 0.019), and households with daughters as household heads (aOR: 1.901, CI: 1.231-2.935, p = 0.004) and being in more than one union (aOR: 2.374, CI: 1.805-3.123, p<0.001) were significantly more likely to smoke cigarette compared to women from southern region, those affiliated to Anglican church, those with husband as household heads, and being in one union respectively. CONCLUSION Cigarette smoking among breastfeeding women in PNG is relatively high, and region of residence, religion, relationship to household head, and the number of unions remain independent predictors. Interventions should target the individual socio-economic and cultural contexts within which breastfeeding occurs.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | | | - Naomi Gyamfi
- Faculty of Medicine and Health, School of Health, University of New England, Armidale NSW, Australia
| | - Bernard Yeboah-Asiamah Asare
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Kent Street, Perth, Australia
- Institute of Applied of Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Dickson Boateng
- Department of Geography, Mary Immaculate College, University of Limerick, Limerick, Ireland
| | | | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- College of Public Health, Medical and Veterniary Sciences, James Cook University, Townsville, Queensland, Australia
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Pereira B, Figueiredo B, Miguel Pinto T, Míguez MC. Tobacco consumption from the 1st trimester of pregnancy to 7 months postpartum: Effects of previous tobacco consumption, and depression and anxiety symptoms. Addict Behav 2022; 124:107090. [PMID: 34464914 DOI: 10.1016/j.addbeh.2021.107090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/31/2021] [Accepted: 08/18/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Previous tobacco consumption, and depression and anxiety symptoms are major predictors of women's tobacco consumption during pregnancy and the postpartum period. However, the joint effect of these predictors is still unexplored. This study aimed to analyse the effects of previous tobacco consumption, and depression and anxiety symptoms on women's tobacco consumption status and quantity from the 1st trimester of pregnancy to 7 months postpartum. METHOD A sample of 803 Spanish women was assessed at the 1st and the 3rd trimester of pregnancy, and at 2 and 7 months postpartum. Previous tobacco consumption, and depression and anxiety symptoms were self-reported. Pregnancy and postpartum tobacco consumption were confirmed with biochemical tests. RESULTS Women with more previous tobacco consumption or more anxiety symptoms presented a steeper decrease in the number of cigarettes smoked per week from the 1st trimester of pregnancy to the childbirth, although smoking more cigarettes than women with less previous tobacco consumption or less anxiety symptoms. Women with more depression symptoms showed a higher tendency to relapse smoking during the first 2 months postpartum. CONCLUSIONS Previous tobacco consumption and anxiety symptoms were associated with higher smoking quantity during pregnancy, while depression symptoms were associated with consumption relapse during postpartum period.
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Affiliation(s)
- Beatriz Pereira
- University of Santiago de Compostela, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain
| | - Bárbara Figueiredo
- University of Minho, School of Psychology, Campus de Gualtar, Braga, Portugal
| | - Tiago Miguel Pinto
- University of Minho, School of Psychology, Campus de Gualtar, Braga, Portugal
| | - M Carmen Míguez
- University of Santiago de Compostela, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
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Smoking and Smoking Relapse in Postpartum: A Systematic Review and Meta-analysis. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nordhagen LS, Kreyberg I, Bains KES, Carlsen K, Glavin K, Skjerven HO, Småstuen MC, Hilde K, Nordlund B, Vettukattil R, Hedlin G, Granum B, Jonassen CM, Gudmundsdóttir HK, Haugen G, Rehbinder EM, Söderhäll C, Staff AC, Lødrup Carlsen KC, Asarnoj A, Lødrup Carlsen OC, Wik Despriée Å, Dyrseth V, Endre KA, Granlund PA, Holmstrøm H, Håland G, Mägi CO, Nygaard UC, Rudi K, Saunders CM, Sjøborg KD, Skrindo I, Tedner SG, Værnesbranden MR, Wiik J. Maternal use of nicotine products and breastfeeding 3 months postpartum. Acta Paediatr 2020; 109:2594-2603. [PMID: 32274823 DOI: 10.1111/apa.15299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 01/19/2023]
Abstract
AIM We aimed to determine the prevalence of and factors associated with maternal use of nicotine products in relation to breastfeeding. METHODS Nicotine use 3 months postpartum was determined in the Scandinavian PreventADALL mother-child birth cohort study recruiting 1837 women from 2014 to 2016. Electronic questionnaires at 18 weeks pregnancy and 3 months postpartum provided information on snus use, smoking or other nicotine use, infant feeding and socio-economic factors. The risk of nicotine use in relation to breastfeeding was analysed with logistic regression. RESULTS Overall, 5.6% of women used snus (2.9%), smoked (2.7%) or both (n = 2) 3 months postpartum, while one used other nicotine products. Among the 1717 breastfeeding women, 95.1% reported no nicotine use, while 2.4% used snus, 2.5% smoked and one dual user. Compared to 3.7% nicotine use in exclusively breastfeeding women (n = 1242), the risk of nicotine use increased by partly (OR 2.26, 95% CI 1.45-3.52) and no breastfeeding (OR 4.58, 95% CI 2.57-8.21). Nicotine use before (14.5% snus, 16.4% smoking) or in pregnancy (0.2% snus, 0.4% smoking) significantly increased the risk of using nicotine during breastfeeding. CONCLUSION Few breastfeeding women used snus or smoked 3 months postpartum, with increased risk by nicotine use before or during pregnancy.
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Affiliation(s)
- Live S. Nordhagen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- VID Specialized University Oslo Norway
| | - Ina Kreyberg
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Karen Eline S. Bains
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Kai‐Håkon Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Håvard O. Skjerven
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | | | - Katarina Hilde
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Berit Granum
- Department of Environmental Health Norwegian Institute of Public Health Oslo Norway
| | - Christine M. Jonassen
- Faculty of Chemistry, Biotechnology and Food Science Norwegian University of Life Sciences Ås Norway
- Genetic Unit Centre for Laboratory Medicine Østfold Hospital Trust Kalnes Norway
| | - Hrefna K. Gudmundsdóttir
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anne Cathrine Staff
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Obstetrics and Gynaecology Oslo University Hospital Oslo Norway
| | - Karin C. Lødrup Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway
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Factors Associated with Smoking Relapse in the Early Postpartum Period: A Prospective Longitudinal Study in Spain. Matern Child Health J 2020; 25:998-1006. [DOI: 10.1007/s10995-020-03019-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
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Dascăl MD, Meghea CI, Blaga OM. A Cross-Section Study of Relationship Characteristics and Smoking Cessation During Pregnancy in a Sample of Romanian Pregnant Women. Matern Child Health J 2020; 24:1113-1120. [PMID: 32048171 DOI: 10.1007/s10995-020-02898-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Partner support and relationship characteristics may be important factors in effective couple-based pregnancy smoking cessation programs. Research is needed to investigate the links between couple relationship characteristics and maternal smoking cessation to inform the development of such interventions. METHODS This paper relies on cross-section data collected during the formative phase in the development of an ongoing couple-focused pregnancy tobacco cessation trial. Data (n = 143 pregnant women) were collected from two large public and one private obstetrics and gynecology clinics located in Cluj-Napoca, Romania. Multiple logistic regression was used to identify correlates of smoking cessation during pregnancy. RESULTS Higher education was a significant correlate of smoking cessation during pregnancy. Women with a college degree or more had higher odds to quit smoking during pregnancy in comparison to their counterparts who graduated high school or less (OR 14.3, 95% CI 2.75-74.28). In addition, women with increased positive partner interactions related to their smoking cessation efforts correlated with higher odds of quitting smoking during pregnancy (OR 1.48, 95% CI 1.15-1.91). DISCUSSION While pregnancy tobacco cessation interventions with partner support do exist, most were not successful and did not focus on couple-related concepts such as partner interactions, dyadic coping, and dyadic efficacy. The findings of the study are important because they bring new insights regarding the potential role of relationship characteristics to inform future cessation programs focused on pregnant smokers and their life partners.
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Affiliation(s)
- Marina Denisa Dascăl
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cristian Ioan Meghea
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, A627 East Fee Hall, East Landing, USA
| | - Oana Maria Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania. .,Department of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.
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12
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Le Lous M, Torchin H. [Smoking and Breastfeeding - CNGOF-SFT Expert Report and Guidelines on the management for Smoking Management During Pregnancy]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:612-618. [PMID: 32247096 DOI: 10.1016/j.gofs.2020.03.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The consequences of smoking have been studied more during pregnancy than during breastfeeding. There is a passage of nicotine and other substances in breast milk and some modifications of milk composition. The objectives of this chapter are to study the benefits of breastfeeding in women who smoke, and the adaptation of smoking, medication and behavioral habits in case of incomplete withdrawal to better guide women. METHODS The Medline database, the Cochrane Library and foreign guidelines from 1999 to 2019 have been consulted. RESULTS The conservation of the benefit of breastfeeding in smokers with regard to the prevention of respiratory infections, infantile colic, cognitive deficits, obesity, sudden infant death, is not known to date. It is therefore not recommended to include smoking status in the choice of feeding mode for the newborn (professional agreement). However, since breastfeeding is a factor associated with a reduction in smoking and/or withdrawal (NP2), it is recommended to promote breastfeeding in non-weaned women in order to limit smoking (grade B). The use of nicotine replacement therapy is possible during breastfeeding (professional agreement). In the absence of data, bupropion (Zyban®) and varenicline (Champix®) are not recommended for women who are breastfeeding (professional agreement). A free interval between smoking and breastfeeding reduces the concentration of nicotine in milk (NP4). For non-weaned women who are breastfeeding, it is therefore recommended not to smoke just before breastfeeding (professional agreement). CONCLUSION The results indicate that breastfeeding is possible in smokers, although less often initiated by them. If the conservation of its benefits for the child is not demonstrated to date, breastfeeding allows the mother to limit smoking.
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Affiliation(s)
- M Le Lous
- Département de gynécologie-obstétrique et médecine de la reproduction, centre hospitalier universitaire de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France; UMR 1099, LTSI-Inserm, université de Rennes 1, 35000 Rennes, France.
| | - H Torchin
- Groupe hospitalier Cochin-hôtel dieu, service de médecine et réanimation néonatale de Port-Royal, Assistance publique-hôpitaux de Paris, 123, boulevard de Port-Royal, 75014 Paris, France; Inserm, Inra, centre de recherche épidémiologie et statistique Sorbonne Paris Cité, université de Paris, 75004 Paris, France
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13
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Reynolds CME, Egan B, O'Malley EG, Kennedy RAK, Sheehan SR, Turner MJ. A longitudinal, observational study of women who persisted in smoking in successive pregnancies. J Public Health (Oxf) 2020; 42:e18-e25. [PMID: 30608605 DOI: 10.1093/pubmed/fdy222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 04/10/2018] [Accepted: 12/06/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This longitudinal study examined the profile and pregnancy-related behaviours of women who reported smoking in two successive pregnancies when they presented for prenatal care in a large maternity hospital. METHODS Using the hospital electronic medical records, women who delivered two successive singleton pregnancies during the years 2011-15 were analyzed. Standardized data were computerized by a midwife at the first prenatal visit, following delivery and before discharge. RESULTS Over the 5 years, 6647 women delivered twice. Overall 5754 (86.6%) were persistent non-smokers in both pregnancies, 609 (9.2%) were persistent smokers in both pregnancies and between pregnancies 202 (3.0%) quit and 82 (1.2%) started smoking. Compared with persistent non-smokers, persistent smokers had higher rates of reported illicit drug use, alcohol consumption and psychological problems and lower rates of planned pregnancy, folic acid supplementation and breastfeeding in both pregnancies (all P < 0.001). In persistent smokers, folic acid supplementation practices deteriorated and illicit drug use increased in the subsequent pregnancy. CONCLUSIONS We found that approximately one in 10 women smoked in two consecutive pregnancies. Furthermore, compared with non-smokers, persistent smokers were more likely to report other health behaviours associated with adverse pregnancy outcomes and may require additional multidisciplinary support.
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Affiliation(s)
- C M E Reynolds
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland.,UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland
| | - B Egan
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.,School of Health and Human Performance, Dublin City University, Ireland
| | - E G O'Malley
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - R A K Kennedy
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - S R Sheehan
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
| | - M J Turner
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Ireland
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Pansieri C, Clavenna A, Pandolfini C, Zanetti M, Calati MG, Miglio D, Cartabia M, Zanetto F, Bonati M. NASCITA Italian birth cohort study: a study protocol. BMC Pediatr 2020; 20:80. [PMID: 32075601 PMCID: PMC7029570 DOI: 10.1186/s12887-020-1961-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 02/06/2020] [Indexed: 01/15/2023] Open
Abstract
Background Young children’s healthy development depends on nurturing care, which ensures health, nutrition, responsive caregiving, safety and security, and early learning. Infancy and childhood are characterized by rapid growth and development, and these two factors contribute largely to determining health status and well-being across the lifespan. Identification of modifiable risk factors and prognostic factors during the critical periods of life will contribute to the development of effective prevention and intervention strategies. The NASCITA (NAscere e creSCere in ITAlia) study was created to evaluate physical, cognitive, and psychological development, health status and health resource utilization during the first six years of life in a cohort of newborns, and to evaluate potential associated factors. Methods NASCITA is an ongoing, dynamic, prospective, population-based birth cohort study of an expected number of more than 5000 newborns who will be recruited in 22 national geographic clusters starting in 2019. It was designed to follow children from birth to school entry age for a wide range of determinants, disorders, and diseases. Recruitment of the newborns (and their parents) will take place during the first routine well-child visit, which takes place at the office of the pediatrician assigned to them by the local health unit of residence, and which is scheduled for all newborns born in Italy within the first 45 days of their life. Data will be web-based and collected by the family pediatricians during each of the 7 standard well-child visits scheduled for all children during their first 6 years of life. Information on every contact with the enrolled children in addition to these prescheduled visits will be also recorded. Discussion The NASCITA cohort study provides a framework in which children are followed from birth to six-years of age. NASCITA will broaden our understanding of the contribution of early-life factors to infant and child health and development. NASCITA provides opportunities to initiate new studies, also experimental ones, in parts of the cohort, and will contribute relevant information on determinants and health outcomes to policy and decision makers. Cohort details can be found on https://coortenascita.marionegri.it. Trial registration Clinicaltrials.gov: NCT03894566. Ethics committee approval: 6 February 2019, Verbale N 59.
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Affiliation(s)
- Claudia Pansieri
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Antonio Clavenna
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Pandolfini
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Michele Zanetti
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maria Grazia Calati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Daniela Miglio
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Massimo Cartabia
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Federica Zanetto
- President Associazione Culturale Pediatri (ACP), Narbolia, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Carswell AL, Ward KD, Vander Weg MW, Scarinci IC, Girsch L, Read M, Relyea G, Chen W. Prospective associations of breastfeeding and smoking cessation among low-income pregnant women. MATERNAL & CHILD NUTRITION 2018; 14:e12622. [PMID: 29797420 PMCID: PMC6865900 DOI: 10.1111/mcn.12622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/23/2018] [Accepted: 04/16/2018] [Indexed: 01/27/2023]
Abstract
Although low-income pregnant women have high rates of smoking and low rates of breastfeeding, few studies have examined prospective associations between these risk factors in community samples. Doing so may help improve breast-feeding support programs in this population. We used a secondary analysis of 247 low-income pregnant smokers in Memphis, Tennessee, who were interviewed up to 4 times (twice during pregnancy and twice through 6 months postpartum). Smoking cessation during prepartum and postpartum was defined as a self-report of not smoking for ≥1 week and an expired carbon monoxide level of <10 ppm. Multivariable logistic regression analyses were used to determine whether intent to breastfeed was associated with smoking cessation and whether smoking cessation was associated with actual breastfeeding. Models were adjusted for sociodemographic, pregnancy-related, and smoking-related confounders. Thirty-nine percent of participants intended to breastfeed, and 38% did so. Women who intended to breastfeed were 2 times more likely to quit smoking prepartum (adjusted OR = 1.99, 95% CI [1.06, 3.74]), but not postpartum (adjusted OR = 1.27, 95% CI [0.57, 2.84]). Quitting smoking at baseline and during pregnancy was associated with subsequent breastfeeding (adjusted OR 2.27, 95% CI [1.05, 4.94] and adjusted OR = 2.49, 95% CI [1.21, 5.11]). Low-income women who intended to breastfeed were more likely to quit smoking during pregnancy and those who quit smoking at baseline and prepartum were more likely to breastfeed. Simultaneously supporting breastfeeding and smoking cessation may be very useful to change these important health behaviours among this high-risk population.
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Affiliation(s)
| | - Kenneth D. Ward
- School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | | | | | - Laura Girsch
- School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | - Mary Read
- School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | - George Relyea
- School of Public HealthUniversity of MemphisMemphisTennesseeUSA
| | - Weiyu Chen
- School of Public HealthUniversity of MemphisMemphisTennesseeUSA
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Tan T, Shi L, Chen X, Cai Y. Changes in the smoking behavior of pregnant women andtheir family members during pregnancy: A cross-sectional study in China. Tob Induc Dis 2018; 16:12. [PMID: 31516412 PMCID: PMC6659502 DOI: 10.18332/tid/85493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/06/2018] [Accepted: 02/19/2018] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Studies regarding the changes in smoking behavior of pregnant women have been mostly conducted in high income countries but rarely in China. This study thus focused on investigating the changes in smoking behavior among pregnant women and their family members in China, both before and during pregnancy. METHODS A cross-sectional study was carried out at nine Women and Children’s Hospitals in Shanghai, China, in 2014. A total of 2831 gestational households were recruited. The chi-squared test, paired sample t-test and logistical regression analysis were used during statistical analysis. RESULTS The prevalence of smoking for all household members significantly declined during pregnancy: 76.2% of the pregnant women, 19.2% of their husbands and 14.0% of other family members quit smoking entirely. The average daily cigarette consumption rate decreased from 5.9 to 0.9 among pregnant women, 11.4 to 9.5 for husbands, and 11.4 to 9.5 for other family members (paired sample t-test, p<0.001). The likelihood that husbands continued smoking during pregnancy was significantly lower for those with a shorter history of smoking, had a lower daily cigarette consumption rate and a household registration in Shanghai. CONCLUSIONS The prevalence of smoking among pregnant women, husbands and other family members significantly declines during pregnancy. Thus, pregnancy is most likely a key period in which to provide families with health education regarding the effects of smoking, both during the pregnancy period and in general. Intervention programs designed to reduce smoking among husbands during pregnancy should focus on those with a long history of smoking, a high rate of daily cigarette consumption, and those with household registration not in Shanghai.
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Affiliation(s)
- Tianyu Tan
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Lili Shi
- Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiaowen Chen
- Children's Hospital of Fudan University, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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17
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Riaz M, Lewis S, Naughton F, Ussher M. Predictors of smoking cessation during pregnancy: a systematic review and meta-analysis. Addiction 2018; 113:610-622. [PMID: 29235189 DOI: 10.1111/add.14135] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/09/2016] [Accepted: 12/05/2017] [Indexed: 01/10/2023]
Abstract
AIM To identify factors found in the research literature to be associated with smoking cessation in pregnancy. METHODS Electronic searches of the bibliographic databases of PubMed, EMBASE, PsycINFO, Elsevier, Scopus and ISI Web of Science were conducted to April 2017. All studies reporting factors associated with smoking cessation or continuing smoking during pregnancy were included and reviewed systematically, irrespective of study design. The Newcastle-Ottawa Quality Assessment Scale was used to assess the study quality. The DerSimonian & Laird random-effects model was used to conduct meta-analyses, and where effect estimates were reported for factors included in at least three studies. RESULTS Fifty-four studies, including 505 584 women globally who smoked before pregnancy, 15 clinical trials and 40 observational studies, were included in the review and 36 (65.5%) were considered to be of high quality. This review identified 11 socio-demographic, seven socially related, 19 smoking behaviour-related, five pregnancy-related, six health-related and six psychological factors that were associated significantly with smoking cessation during pregnancy. The most frequently observed significant factors associated with cessation were: higher level of education, pooled odds ratio (OR), 95% confidence interval (CI) = 2.16 (1.80-2.84), higher socio-economic status: 1.97 (1.20-3.24), overseas maternal birth: 2.00 (1.40-2.84), Medicaid coverage or private insurance: 1.54 (1.29-1.85), living with partner or married: 1.49 (1.38-1.61), partner/other members of the household do not smoke: 0.42 (0.35-0.50), lower heaviness of smoking index score: 0.45 (0.27-0.77, lower baseline cotinine level: 0.78 (0.64-0.94), low exposure to second-hand smoking: 0.45 (0.20-1.02), not consuming alcohol before and/or during pregnancy: 2.03 (1.47-2.80), primiparity: 1.85 (1.68-2.05), planned breastfeeding:1.99 (1.94-2.05), perceived adequate pre-natal care: 1.74 (1.38-2.19), no depression: 2.65 (1.62-4.30) and low stress during pregnancy: 0.58 (0.44-0.77). CONCLUSION A wide range of socio-demographics, relationship, social, smoking-related, pregnancy-related, health and psychological factors have been found to predict smoking cessation in pregnancy.
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Affiliation(s)
- Muhammad Riaz
- College of Medicine, Biological Sciences and Psychology, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Michael Ussher
- Population Health Research Institute, St George's University of London, London, UK
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Lok KYW, Wang MP, Chan VHS, Tarrant M. Effect of Secondary Cigarette Smoke from Household Members on Breastfeeding Duration: A Prospective Cohort Study. Breastfeed Med 2018; 13:412-417. [PMID: 29902073 DOI: 10.1089/bfm.2018.0024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Maternal smoking and exposure to tobacco smoke is one modifiable risk factor that affects breastfeeding initiation and duration. We prospectively examine the effects of maternal and paternal smoking and other family members' smoking status on the duration of breastfeeding. MATERIALS AND METHODS A cohort of 1,277 mother-infant pairs admitted to the postpartum units of four major public hospitals in Hong Kong. Demographic data, maternal, paternal and household smoking habits, and other potential confounding variables were collected via self-reported questionnaires during the postnatal hospitalization. Breastfeeding status after hospital discharge was assessed through telephone follow-up up to 12 months postpartum, or until participants were no longer breastfeeding. If the participant had weaned during that follow-up interval, she was asked to report the total duration (in weeks) of both any and exclusive breastfeeding. RESULTS A total of 1,240 (97%) mother-infant pairs completed followed up, 2.5% were smokers, 29.2% of their partners smoked, and 11.3% had another smoker living in their home. Maternal and other family members' smoking predicted breastfeeding cessation. When compared with mothers in nonsmoking family, those exposed to two or more family members who smoked had approximately a 30% increased risk of breastfeeding cessation (adjusted hazard ratio [aHR] = 1.31; 95% CI 1.01-1.68). CONCLUSION Mothers who were exposed to two or more smokers in the household had a significantly shorter duration of any breastfeeding at 12-month follow-up.
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Affiliation(s)
- Kris Y W Lok
- 1 School of Nursing, The University of Hong Kong , Pokfulam, Hong Kong
| | - Man Ping Wang
- 1 School of Nursing, The University of Hong Kong , Pokfulam, Hong Kong
| | - Vincci H S Chan
- 1 School of Nursing, The University of Hong Kong , Pokfulam, Hong Kong
| | - Marie Tarrant
- 2 School of Nursing, University of British Columbia , Kelowna, Canada
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Preconception health behaviours: A scoping review. Prev Med 2017; 96:1-15. [PMID: 27939264 DOI: 10.1016/j.ypmed.2016.11.022] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/20/2016] [Accepted: 11/24/2016] [Indexed: 11/20/2022]
Abstract
Preconception health refers to the health of males and females at any point in time prior to a potential pregnancy. A goal of preconception health research is to use preventive behaviour and healthcare to optimize the health of future offspring that result from both planned and unplanned pregnancies. This paper briefly reviews evidence of the importance of various preconception health behaviours, and examines the extent to which specific preconception health behaviours have been included in recent studies of such knowledge, behaviours, and intentions. To describe this recent research in highly developed countries, a scoping review of the literature was completed of studies published within the past seven years. A total of 94 studies on preconception health were identified and reviewed: (a) 15 examined knowledge and attitudes, (b) 68 studied behaviours, (c) 18 examined interventions designed to improve knowledge or behaviour, and (d) no studies examined intentions to engage in preconception health behaviours. Over 40% of studies examining preconception health behaviour focussed exclusively on folic acid. Overall, folic acid, alcohol, and cigarettes have consistently been topics of focus, while exposure to harmful environmental substances, stress, and sleep have been largely neglected. Despite strong evidence for the importance of men's health during the preconception period, only 11% of all studies included male participants. Based on existing gaps in the research, recommendations are provided, such as including men in future research, assessing a wider variety of behaviours, consideration of behavioural intentions, and consideration of the relationships between preconception health knowledge, intentions, and behaviour.
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Míguez MC, Pereira B, Figueiredo B. Tobacco consumption and spontaneous quitting at the first trimester of pregnancy. Addict Behav 2017; 64:111-117. [PMID: 27608322 DOI: 10.1016/j.addbeh.2016.08.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/22/2016] [Accepted: 08/29/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the association between pregnant women's socio-demographic characteristics, smoking-related variables and psychological symptoms (anxiety and depression) and both tobacco consumption and spontaneous quitting at the first trimester of pregnancy. In particular, we wished to examine the contribution of depressive symptoms to tobacco consumption and spontaneous quitting, while controlling for anxiety symptoms, socio-demographic and smoking-related variables. METHODS The sample was comprised of 901 Spanish pregnant women. Assessment included an ad hoc questionnaire with socio-demographic and tobacco consumption information, the Edinburg Postnatal Depression Scale (EPDS), and The State-Anxiety Inventory (STAI-S). Two multiple logistic regression analyses were performed, respectively to predict tobacco consumption and to predict spontaneous quitting. RESULTS Having a partner who smokes (OR=5.578), not having a college education (OR=2.803), higher scores on the EPDS (OR=1.073) and higher scores on the STAI-S (OR=1.027) increase the probability of continuing smoking. Being primiparous (OR=2.463), having a college education (OR=2.141), smoking fewer cigarettes before pregnancy (OR=1.175), and lower scores on the STAI-S (OR=1.045) increase the probability of spontaneously quitting smoking at the first trimester of pregnancy. CONCLUSIONS Depressive symptoms were a predictor of tobacco consumption but not of spontaneous quitting; spontaneous quitting was better predicted by anxiety symptoms. These findings support recommendations that women with depressive symptoms are at risk for smoking during pregnancy and highlight that anxious symptoms should be targeted in interventions for smoking cessation during pregnancy.
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Hirabayashi M, Yoshinaga M, Nomura Y, Ushinohama H, Sato S, Tauchi N, Horigome H, Takahashi H, Sumitomo N, Shiraishi H, Nagashima M. Environmental risk factors for sudden infant death syndrome in Japan. Eur J Pediatr 2016; 175:1921-1926. [PMID: 27664161 DOI: 10.1007/s00431-016-2786-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 08/09/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022]
Abstract
UNLABELLED While the prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, this decline has plateaued recently. Strategies are needed to resume the constant decrease of SIDS in Japan. A prospective electrocardiographic screening program for infants was performed between July 2010 and March 2011. Parents of 4319 infants were asked about environmental factors related to SIDS through questionnaires at a one-month medical checkup and one year. Parental awareness of prone position, smoke exposure, and breast feeding as environmental factors were 81.4 %, 69.0 %, and 47.8 %, respectively. The prevalence of laying infants exclusively in a supine position was 96.7 %. At the one-month medical checkup, smoking prevalence was 41.7 % in fathers and 2.1 % in mothers. Maternal smoking prevalence was significantly increased at one year after (p < 0.001). Multivariate regression analysis showed that risk factors for new or continued maternal smoking habits were maternal smoking habits at one month (p < 0.001), paternal smoking habits one year later (p < 0.001), and younger maternal age (p = 0.02). CONCLUSION Most parents already avoid laying infants in the prone position, and parental smoking is still a SIDS risk concern in Japan. Smoking cessation programs should be further implemented for parents to decrease risks of SIDS in Japan. What is Known: • The prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, however, this decline has plateaued recently. What is New: • Most infants were laid sleeping in the supine position (96.7 %) and were fed breast milk or a mix of expressed milk and formula (92.7 %), and 2.1 % of mothers smoked at the one-month medical checkup. • Maternal smoking prevalence significantly increased from the one-month medical checkup to one year later, and smoking mothers were more likely to feed infants by formula rather than breast milk. • Independent risk factors for new or continued maternal smoking habits included younger maternal age, maternal smoking habits at one month, and paternal smoking habits one year later.
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Affiliation(s)
- Masako Hirabayashi
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Yuichi Nomura
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 37-1 Uearata-cho, Kagoshima, 890-8760, Japan.
- Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan.
| | - Hiroya Ushinohama
- Department of the Cardiovascular System, Fukuoka Children's Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan
| | - Seiichi Sato
- Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
| | - Nobuo Tauchi
- Department of Rehabilitation, Aichi Saiseikai Rehabilitation Hospital, Nagoya, Japan
| | - Hitoshi Horigome
- Departments of Child Health, University of Tsukuba, Tsukuba, Japan
| | - Hideto Takahashi
- Department of Information Management and Statistics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama International Medical Center, Hidaka, Japan
| | | | - Masami Nagashima
- Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
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Berlin N, Goldzahl L, Jusot F, Berlin I. Protocol for study of financial incentives for smoking cessation in pregnancy (FISCP): randomised, multicentre study. BMJ Open 2016; 6:e011669. [PMID: 27466239 PMCID: PMC4964243 DOI: 10.1136/bmjopen-2016-011669] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Maternal smoking during pregnancy is associated with adverse perinatal and postnatal health outcomes. The efficacy of nicotine replacement therapies in helping pregnant smokers to quit is not clearly demonstrated; therefore new interventions should be proposed and assessed. Financial incentives rewarding abstinence from tobacco smoking is one of the promising options. OBJECTIVE To assess the efficacy of financial incentives on smoking abstinence among French pregnant smokers. PARTICIPANTS pregnant smokers aged ≥18 years, smoking at least five manufactured or three roll-your-own cigarettes per day, and pregnant for <18 weeks of amenorrhoea (WA). SETTING participants will be recruited, included and followed-up at monthly face-to-face visits in 16 maternity wards in France. INTERVENTIONS participants will be randomised to a control or an intervention group. After a predefined quit date, participants in the control group will receive €20 vouchers at the completion of each visit but no financial incentive for smoking abstinence. Participants in the intervention group will be rewarded for their abstinence by vouchers on top of the €20 show-up fee. The amount of reward for abstinence will increase as a function of duration of abstinence to stimulate longer periods of abstinence. MAIN OUTCOME MEASURE complete abstinence from quit date to the last predelivery visit. SECONDARY OUTCOME MEASURES point prevalence abstinence, time to relapse to smoking, birth weight, fetal growth restriction, preterm birth. Main data analysis: outcomes will be analysed on an intention-to-treat (ITT) basis. The ITT population is defined as all randomised smoking pregnant women. ETHICS AND DISSEMINATION The research protocol was approved by the ethics committee (Comité de Protection des Personnes, CPP) of the Pitié-Salpêtrière Hospital on 15 May 2015, and Amendment No 1 was approved on 13 July 2015. Results will be presented at scientific meetings and published. TRIAL REGISTRATION NUMBER NCT02606227; Pre-results.
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Affiliation(s)
- Noémi Berlin
- University of Edinburgh, School of Economics, Edinburgh, UK
| | | | | | - Ivan Berlin
- Department of Pharmacology, Hôpital Pitié-Salpêtrière, Faculté de médecine-Université P. & M. Curie, INSERM U1178, Paris, France
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Nilsen RM, Leoncini E, Gastaldi P, Allegri V, Agostino R, Faravelli F, Ferrazzoli F, Finale E, Ghirri P, Scarano G, Mastroiacovo P. Prevalence and determinants of preconception folic acid use: an Italian multicenter survey. Ital J Pediatr 2016; 42:65. [PMID: 27411491 PMCID: PMC4944255 DOI: 10.1186/s13052-016-0278-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 07/05/2016] [Indexed: 01/17/2023] Open
Abstract
Background Women in many countries are advised to use folic acid supplements before and early during pregnancy to reduce the risk of neural tube defects in their infants. This study aimed to update the prevalence and to identify possible determinants of preconception folic acid supplement use in Italian women. Methods The study was based on cross-sectional data from seven maternity clinics located in six Italian regions from January to June, 2012. Data on maternal characteristics and supplement use were collected for 2,189 women using a self-administered questionnaire. Results Preconception folic acid use was reported by 23.5 % (n = 515) of the participants. Of these, 479 (93 %) women had taken folic acid supplements on a daily basis as recommended by the health authorities. Women who both had intended their pregnancy and had requested a preconception health visit to a doctor/gynecologist were substantially more likely than the reference group to initiate folic acid supplementation before their pregnancy (48.6 versus 4.8 %). Preconception folic acid use was also associated with higher maternal age, higher education, marriage/cohabitation, lower parity, infertility treatments, and chronic disease. Conclusions Data from seven maternity clinics located in six Italian regions indicate that preconception folic acid supplement use in many Italian women is low. Women who do not plan their pregnancy or do not request a preconception health visit to their doctor have among the lowest prevalence of preconception folic acid use. Improving folate status in these and other supplemental non-users may have important disease preventive effects.
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Affiliation(s)
- Roy M Nilsen
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway. .,Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy.
| | - Emanuele Leoncini
- Alessandra Lisi International Centre on Birth Defects and Prematurity, Rome, Italy
| | - Paolo Gastaldi
- Unit (UOC) Obstetrics and Gynecology, Santo Spirito in Saxia Hospital, Roma, Italy
| | | | - Rocco Agostino
- Department of Mother and Child Health, S. Giovanni Calibita-Fatebenefratelli Hospital, Rome, Italy
| | | | | | - Enrico Finale
- Unit of Obstetrics and Gynecology, Castelli Hospital, Verbania, Italy
| | - Paolo Ghirri
- Unit of Neonatology and Neonatal Intensive Care, Azienda Ospedaliero-Univesitaria Pisana, Pisa, Italy
| | - Gioacchino Scarano
- Department of Medical Genetics, Gaetano Rummo Hospital, Benevento, Italy
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Zacharasiewicz A. Maternal smoking in pregnancy and its influence on childhood asthma. ERJ Open Res 2016; 2:00042-2016. [PMID: 27730206 PMCID: PMC5034599 DOI: 10.1183/23120541.00042-2016] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 06/05/2016] [Indexed: 12/16/2022] Open
Abstract
Maternal smoking in pregnancy (MSP) is a large modifiable risk factor for pregnancy related mortality and morbidity and also the most important known modifiable risk factor for asthma. This review summarises the effects of MSP throughout infancy, childhood and adolescence with regards to asthma (development and severity). Firstly, the direct damage caused by nicotine on fetal lung development, fetal growth and neuronal differentiation is discussed, as well as the indirect effects of nicotine on placental functioning. Secondly, the effects of MSP on later immune functioning resulting in increased infection rate are summarised and details are given on the effects of MSP modulating airway hyperreactivity, reducing lung function and therefore increasing asthma morbidity. Furthermore, epigenetic effects are increasingly being recognised. These can also result in transgenerational detrimental effects induced by cigarette smoke. In summary, the causal relationship between MSP and asthma development is well documented and presents a major health problem for generations to come. The high prevalence of MSP is alarming and epigenetic effects of nicotine on immune functioning potentiate this danger. A considerable part of the increase in asthma prevalence worldwide is due to MSP.
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Affiliation(s)
- Angela Zacharasiewicz
- Dept of Pediatrics and Adolescent Medicine, Teaching Hospital Wilhelminenspital of the Medical University of Vienna, Vienna, Austria
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25
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Jones M, Lewis S, Parrott S, Wormall S, Coleman T. Re-starting smoking in the postpartum period after receiving a smoking cessation intervention: a systematic review. Addiction 2016; 111:981-90. [PMID: 26990248 PMCID: PMC6680353 DOI: 10.1111/add.13309] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/18/2015] [Accepted: 01/04/2016] [Indexed: 11/28/2022]
Abstract
AIMS In pregnant smoking cessation trial participants, to estimate (1) among women abstinent at the end of pregnancy, the proportion who re-start smoking at time-points afterwards (primary analysis) and (2) among all trial participants, the proportion smoking at the end of pregnancy and at selected time-points during the postpartum period (secondary analysis). METHODS Trials identified from two Cochrane reviews plus searches of Medline and EMBASE. Twenty-seven trials were included. The included trials were randomized or quasi-randomized trials of within-pregnancy cessation interventions given to smokers who reported abstinence both at end of pregnancy and at one or more defined time-points after birth. Outcomes were validated biochemically and self-reported continuous abstinence from smoking and 7-day point prevalence abstinence. The primary random-effects meta-analysis used longitudinal data to estimate mean pooled proportions of re-starting smoking; a secondary analysis used cross-sectional data to estimate the mean proportions smoking at different postpartum time-points. Subgroup analyses were performed on biochemically validated abstinence. RESULTS The pooled mean proportion re-starting at 6 months postpartum was 43% [95% confidence interval (CI) = 16-72%, I(2) = 96.7%] (11 trials, 571 abstinent women). The pooled mean proportion smoking at the end of pregnancy was 87% (95% CI = 84-90%, I(2) = 93.2%) and 94% (95% CI = 92-96%, I(2) = 88%) at 6 months postpartum (23 trials, 9262 trial participants). Findings were similar when using biochemically validated abstinence. CONCLUSIONS In clinical trials of smoking cessation interventions during pregnancy only 13% are abstinent at term. Of these, 43% re-start by 6 months postpartum.
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Affiliation(s)
- Matthew Jones
- Division of Primary CareUniversity of NottinghamNottinghamUK
| | - Sarah Lewis
- Division of Epidemiology and Public HealthUniversity of NottinghamNottinghamUK
| | - Steve Parrott
- Department of Health SciencesUniversity of YorkYorkUK
| | - Stephen Wormall
- Division of Primary CareUniversity of NottinghamNottinghamUK
| | - Tim Coleman
- Division of Primary CareUniversity of NottinghamNottinghamUK
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Morgan H, Hoddinott P, Thomson G, Crossland N, Farrar S, Yi D, Hislop J, Moran VH, MacLennan G, Dombrowski SU, Rothnie K, Stewart F, Bauld L, Ludbrook A, Dykes F, Sniehotta FF, Tappin D, Campbell M. Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design. Health Technol Assess 2016; 19:1-522, vii-viii. [PMID: 25897655 DOI: 10.3310/hta19300] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby. AIM To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design. DESIGN Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods. Two mother-and-baby groups in disadvantaged areas collaborated throughout. SETTING UK. PARTICIPANTS The qualitative study included 88 pregnant women/recent mothers/partners, 53 service providers, 24 experts/decision-makers and 63 conference attendees. The surveys included 1144 members of the general public and 497 health professionals. The DCE study included 320 women with a history of smoking. METHODS (1) Evidence syntheses: incentive effectiveness (including meta-analysis and effect size estimates), delivery processes, barriers to and facilitators of smoking cessation in pregnancy and/or breastfeeding, scoping review of incentives for lifestyle behaviours; (2) qualitative research: grounded theory to understand incentive mechanisms of action and a framework approach for trial design; (3) survey: multivariable ordered logit models; (4) DCE: conditional logit regression and the log-likelihood ratio test. RESULTS Out of 1469 smoking cessation and 5408 breastfeeding multicomponent studies identified, 23 smoking cessation and 19 breastfeeding studies were included in the review. Vouchers contingent on biochemically proven smoking cessation in pregnancy were effective, with a relative risk of 2.58 (95% confidence interval 1.63 to 4.07) compared with non-contingent incentives for participation (four studies, 344 participants). Effects continued until 3 months post partum. Inconclusive effects were found for breastfeeding incentives compared with no/smaller incentives (13 studies) but provider commitment contracts for breastfeeding show promise. Intervention intensity is a possible confounder. The acceptability of seven promising incentives was mixed. Women (for vouchers) and those with a lower level of education (except for breastfeeding incentives) were more likely to disagree. Those aged ≤ 44 years and ethnic minority groups were more likely to agree. Agreement was greatest for a free breast pump and least for vouchers for breastfeeding. Universal incentives were preferred to those targeting low-income women. Initial daily text/telephone support, a quitting pal, vouchers for > £20.00 per month and values up to £80.00 increase the likelihood of smoking cessation. Doctors disagreed with provider incentives. A 'ladder' logic model emerged through data synthesis and had face validity with service users. It combined an incentive typology and behaviour change taxonomy. Autonomy and well-being matter. Personal difficulties, emotions, socialising and attitudes of others are challenges to climbing a metaphorical 'ladder' towards smoking cessation and breastfeeding. Incentive interventions provide opportunity 'rungs' to help, including regular skilled flexible support, a pal, setting goals, monitoring and outcome verification. Individually tailored and non-judgemental continuity of care can bolster women's capabilities to succeed. Rigid, prescriptive interventions placing the onus on women to behave 'healthily' risk them feeling pressurised and failing. To avoid 'losing face', women may disengage. LIMITATIONS Included studies were heterogeneous and of variable quality, limiting the assessment of incentive effectiveness. No cost-effectiveness data were reported. In surveys, selection bias and confounding are possible. The validity and utility of the ladder logic model requires evaluation with more diverse samples of the target population. CONCLUSIONS Incentives provided with other tailored components show promise but reach is a concern. Formal evaluation is recommended. Collaborative service-user involvement is important. STUDY REGISTRATION This study is registered as PROSPERO CRD42012001980. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Heather Morgan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Pat Hoddinott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Shelley Farrar
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Deokhee Yi
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jenni Hislop
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Victoria Hall Moran
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Kieran Rothnie
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Fiona Stewart
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Linda Bauld
- The Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Anne Ludbrook
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Fiona Dykes
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Falko F Sniehotta
- Institute of Health and Society, University of Newcastle, Newcastle, UK
| | - David Tappin
- Perinatal Epidemiology and Child Health Unit, School of Medicine, University of Glasgow, Glasgow, UK
| | - Marion Campbell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Esposito G, Ambrosio R, Napolitano F, Di Giuseppe G. Women's Knowledge, Attitudes and Behavior about Maternal Risk Factors in Pregnancy. PLoS One 2015; 10:e0145873. [PMID: 26714032 PMCID: PMC4694714 DOI: 10.1371/journal.pone.0145873] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 12/09/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aims of this study were to assess the levels of knowledge, attitudes and behaviors of women about the main maternal risk factors in pregnancy and to identify the factors linked to the main outcomes of interest. MATERIALS AND METHODS A cross-sectional survey was conducted in 513 pregnant women randomly selected from the gynecological ambulatory services of five hospitals located in Naples, Italy. RESULTS Only 42% of women correctly knew all the main maternal risk factors in pregnancy (alcohol, smoking, passive smoking and obesity). Only 21.7% of women were very worried about causing harm to the fetus or child with their risk behaviors, and 22.3% of women reported smoking during pregnancy. Approximately one-third of women (28.9%) reported regularly drinking alcohol before pregnancy and 74.8% of these women reported stopping drinking alcohol during pregnancy. However, only 27.3% of women who were drinking alcohol during pregnancy had the intention of stopping. Only 43.7% of women indicated that during ambulatory gynecological examinations they received information from physicians about the possible damage resulting from all the main risk factors in pregnancy (alcohol, smoking, passive smoking and obesity). CONCLUSION The results indicate that pregnant women lack knowledge regarding the main maternal risk factors. Pregnant women claim to receive little information during gynecological examinations and, therefore, some continue to smoke and drink alcohol during pregnancy. Our results suggest an urgent need for the design of interventions to improve women's levels of knowledge and to promote appropriate behavior in relation to the major risk factors in pregnancy.
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Affiliation(s)
- Giuseppe Esposito
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
- * E-mail:
| | - Rossella Ambrosio
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
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Banderali G, Martelli A, Landi M, Moretti F, Betti F, Radaelli G, Lassandro C, Verduci E. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med 2015; 13:327. [PMID: 26472248 PMCID: PMC4608184 DOI: 10.1186/s12967-015-0690-y] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 10/07/2015] [Indexed: 01/19/2023] Open
Abstract
A great deal of attention has been focused on adverse effects of tobacco smoking on conception, pregnancy, fetal, and child health. The aim of this paper is to discuss the current evidence regarding short and long-term health effects on child health of parental smoking during pregnancy and lactation and the potential underlying mechanisms. Studies were searched on MEDLINE(®) and Cochrane database inserting, individually and using the Boolean ANDs and ORs, 'pregnancy', 'human lactation', 'fetal growth', 'metabolic outcomes', 'obesity', 'cardiovascular outcomes', 'blood pressure', 'brain development', 'respiratory outcomes', 'maternal or paternal or parental tobacco smoking', 'nicotine'. Publications coming from the reference list of studies were also considered from MEDLINE. All sources were retrieved between 2015-01-03 and 2015-31-05. There is overall consistency in literature about negative effects of fetal and postnatal exposure to parental tobacco smoking on several outcomes: preterm birth, fetal growth restriction, low birth weight, sudden infant death syndrome, neurodevelopmental and behavioral problems, obesity, hypertension, type 2 diabetes, impaired lung function, asthma and wheezing. While maternal smoking during pregnancy plays a major role on adverse postnatal outcomes, it may also cumulate negatively with smoking during lactation and with second-hand smoking exposure. Although this review was not strictly designed as a systematic review and the PRISMA Statement was not fully applied it may benefit the reader with a promptly and friendly readable update of the matter. This review strengthens the need to plan population health policies aimed to implement educational programs to hopefully minimize tobacco smoke exposure during pregnancy and lactation.
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Affiliation(s)
- G Banderali
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - A Martelli
- U.O.C. Pediatria Presidio Ospedaliero Garbagnate Milanese Azienda Ospedaliera G. Salvini, Milan, Italy.
| | - M Landi
- Pediatrician Primary Care, Institute of Biomedicine and Molecular Immunology, National Research Council, CNR, Palermo, Italy.
| | - F Moretti
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
- Nutritional Sciences, University of Milan, Milan, Italy.
| | - F Betti
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - G Radaelli
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
| | - C Lassandro
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
- Nutritional Sciences, University of Milan, Milan, Italy.
| | - E Verduci
- Department of Pediatrics, San Paolo Hospital, Via A Di Rudinì 8, 20142, Milan, Italy.
- Department of Health Sciences, University of Milan, Via A Di Rudinì 8, 20142, Milan, Italy.
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The relationship between maternal-fetal attachment and cigarette smoking over pregnancy. Matern Child Health J 2014; 18:1017-22. [PMID: 23892790 DOI: 10.1007/s10995-013-1330-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cigarette smoking during pregnancy is one of the most preventable causes of infant morbidity and mortality, yet 80 % of women who smoked prior to pregnancy continue to smoke during pregnancy. Past studies have found that lower maternal-fetal attachment predicts smoking status in pregnancy, yet past research has not examined whether maternal-fetal attachment predicts patterns or quantity of smoking among pregnant smokers. The aim of this study was to examine the relationship between maternal-fetal attachment and patterns of maternal smoking among pregnant smokers. We used self-reported and biochemical markers of cigarette smoking in order to better understand how maternal-fetal attachment relates to the degree of fetal exposure to nicotine. Fifty-eight pregnant smokers participated in the current study. Women completed the Maternal-Fetal Attachment Scale, reported weekly smoking behaviors throughout pregnancy using the Timeline Follow Back interview, and provided a saliva sample at 30 and 35 weeks gestation and 1 day postpartum to measure salivary cotinine concentrations. Lower maternal-fetal attachment scores were associated with higher salivary cotinine at 30 weeks gestation and 1 day postpartum. As well, women who reported lower fetal attachment reported smoking a greater maximum number of cigarettes per day, on average, over pregnancy. Lower maternal-fetal attachment is associated with greater smoking in pregnancy. Future research might explore whether successful smoking cessation programs improve maternal assessments of attachment to their infants.
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Mastroiacovo P, Nilsen RM, Leoncini E, Gastaldi P, Allegri V, Boiani A, Faravelli F, Ferrazzoli F, Guala A, Madrigali V, Scarano G. Prevalence of maternal preconception risk factors: an Italian multicenter survey. Ital J Pediatr 2014; 40:91. [PMID: 25416843 PMCID: PMC4264313 DOI: 10.1186/s13052-014-0091-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/07/2014] [Indexed: 11/24/2022] Open
Abstract
Objectives Adequate preconception maternal health care is essential to reduce the risk of unwanted pregnancy outcomes and complications. Still, many women are exposed to a number of unhealthy risk factors both before and early in pregnancy. This study aimed to estimate the prevalence of a number of important preconception risk factors using data from a recent multicenter study in Italy. Methods The study was based on cross-sectional data from seven maternity clinics located in six different regions in Italy during the period January – June, 2012. Data on maternal preconception risk factors and characteristics were collected from 1,892 women who delivered healthy children and 320 women who were pregnant in the first trimester. Results About 97% of the women (n = 2,212) were exposed to one or more preconception risk factors. The overall prevalence of the most essential maternal risk factors was as follows: 41% had a age ≥35 years, 36% mistimed or did not intend their pregnancy, 58% did not request a preconception health visit to their doctor, 76% did not use folic acid supplements before pregnancy, 26% smoked at the last menstrual period, 19% had a body mass index ≥25 kg/m2 before pregnancy, and 10% suffered from pregestational chronic diseases. The prevalence of certain variables varied between the maternity clinics. Conclusions Many Italian women are exposed to a number of preconception risk factors that have been associated with adverse pregnancy complications and outcomes. More effective intervention programs to improve preconception health in Italian women are strongly needed.
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Smoking patterns, depression, and sociodemographic variables among Flemish women during pregnancy and the postpartum period. Nurs Res 2014; 62:394-404. [PMID: 24165215 DOI: 10.1097/nnr.0b013e3182a59d96] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Relationships among feelings of depression, smoking behavior, and educational level during pregnancy have been documented. Feelings of depression may contribute to persistent smoking during pregnancy. No longitudinal studies assessing feelings of depression in women with different antepartum and postpartum smoking patterns are available. OBJECTIVES The aim was to determine relationships between depressive symptoms, sociodemographic characteristics, and smoking pattern during and after pregnancy. METHODS An observational, prospective, noninterventional study was conducted. Data were collected during two stages of pregnancy (T0: <;16 weeks and T1: 32-34 weeks) and postpartum (T2: >6 weeks) in 523 Flemish women. Feelings of depression (measured using the Beck Depression Inventory [BDI]), smoking behavior, and sociodemographic variables were analyzed using a general linear mixed model implemented in SAS Proc MIXED. RESULTS Smokers and initial smokers reported significantly more depressive symptoms at all time points compared with recent ex-smokers, nonsmokers, and initial nonsmokers (p <; .001). The three-way interaction among time point, smoking pattern, and educational level was significant (p = .02). Evolution of mean BDI over time differed by educational level. Among participants with a secondary school certificate or less, differences were observed between smokers and nonsmokers, recent ex-smokers and initial nonsmokers, and nonsmokers and initial nonsmokers. Among participants with a college or university degree, no differences were observed. DISCUSSION A wide variety of smoking patterns were observed during pregnancy and early postpartum. Smoking patterns were associated with depression and showed complex interactions with educational level. Assessment and intervention for both smoking and depression are needed throughout the perinatal period to support the health of mothers, their infants, and families.
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Smoking and pregnancy--a review on the first major environmental risk factor of the unborn. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6485-99. [PMID: 24351784 PMCID: PMC3881126 DOI: 10.3390/ijerph10126485] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/12/2013] [Accepted: 11/13/2013] [Indexed: 12/23/2022]
Abstract
Smoking cigarettes throughout pregnancy is one of the single most important avoidable causes of adverse pregnancy outcomes and it represents the first major environmental risk of the unborn. If compared with other risk factors in the perinatal period, exposure to tobacco smoke is considered to be amongst the most harmful and it is associated with high rates of long and short term morbidity and mortality for mother and child. A variety of adverse pregnancy outcomes are linked with cigarette consumption before and during pregnancy. Maternal prenatal cigarette smoke disturbs the equilibrium among the oxidant and antioxidant system, has negative impact on the genetic and cellular level of both mother and fetus and causes a large quantity of diseases in the unborn child. These smoking-induced damages for the unborn offspring manifest themselves at various times in life and for most only a very limited range of causal treatment exists. Education, support and assistance are of high importance to decrease maternal and fetal morbidity and mortality, as there are few other avoidable factors which influence a child's health that profoundly throughout its life. It is imperative that smoking control should be seen as a public health priority.
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Karp SM, Howe-Heyman A, Dietrich MS, Lutenbacher M. Breastfeeding initiation in the context of a home intervention to promote better birth outcomes. Breastfeed Med 2013; 8:381-7. [PMID: 23484671 PMCID: PMC3726024 DOI: 10.1089/bfm.2012.0151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This secondary analysis examined breastfeeding initiation rates and factors related to initiation in a sample of multiparous women with a history of a prior preterm birth. SUBJECTS AND METHODS Data for a subsample of women (n=130) were derived from a randomized clinical trial testing a home visit intervention to improve birth outcomes. The subsample included women who gave birth to an infant greater than 35 weeks of gestation. All participants received standard prenatal care. Intervention participants (n=73) also received home visits by certified nurse-midwives. Visits were guided by protocols to improve factors associated with poor birth outcomes and maternal and infant health. Descriptive and logistic regression analyses were used, controlling for factors previously associated with breastfeeding. RESULTS Although 85% of women reported an intention to breastfeed, only 65% reported initiating breastfeeding at 48 hours postpartum. After controlling for race, income, marital status, smoking, and age, higher maternal education and lower pregravid body mass index were associated with higher rates of initiation (odds ratio [OR]=1.30, p=0.010 and OR=0.94, p=0.007, respectively). Lower levels of depressive symptoms (OR=0.95, p=0.039) and higher levels of prenatal stress (OR=1.11, p=0.042) increased the likelihood of initiating breastfeeding. No difference between groups emerged, although women in the intervention group with more home visit time were more likely to report breastfeeding (p=0.007). CONCLUSIONS Modifiable risk factors were associated with rates of breastfeeding initiation. It may be possible to use protocols delivered via nurse-midwife home visits within a global intervention to increase breastfeeding initiation.
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Affiliation(s)
- Sharon M Karp
- Schools of Nursing and Medicine (Division of General Pediatrics), Vanderbilt University, Nashville, TN 37240, USA.
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Barthold JS, Hossain J, Olivant-Fisher A, Reilly A, Figueroa TE, Banihani A, Hagerty J, González R, Noh PH, Manson JM. Altered infant feeding patterns in boys with acquired nonsyndromic cryptorchidism. BIRTH DEFECTS RESEARCH. PART A, CLINICAL AND MOLECULAR TERATOLOGY 2012; 94:900-7. [PMID: 23081935 PMCID: PMC3501569 DOI: 10.1002/bdra.23075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 07/11/2012] [Accepted: 07/26/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Genetic and environmental factors likely influence susceptibility to nonsyndromic cryptorchidism, a common disease presenting at birth or in later childhood. We compared cases and controls to define differential risk factors for congenital versus acquired cryptorchidism. METHODS We compared questionnaire and clinical data from cases of congenital cryptorchidism (n = 230), acquired cryptorchidism (n = 182) and hernia/hydrocele (n = 104) with a group of healthy male controls (n = 358). Potential predictor variables (p < 0.2 in univariable analysis) were included in stepwise multivariable logistic regression models. RESULTS Temporary (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.4-0.8) or exclusive (OR, 0.6; 95% CI, 0.4-0.9) breastfeeding was reduced and soy formula feeding increased (OR, 1.8; 95% CI, 1.2-2.9) in acquired but not congenital or hernia/hydrocele groups. The highest risk estimates were observed for primary soy formula feeding with limited or no breastfeeding (OR 2.5; 95% CI, 1.4-4.3; adjusted OR, 2.7; 95% CI, 1.4-5.4) in the acquired group. Primary feeding risk estimates were equivalent or strengthened when multivariable models were limited to age greater than 2 years, full-term or not small for gestational age, or Caucasian subjects. Pregnancy complications and increased maternal exposure to cosmetic or household chemicals were not consistently associated with either form of cryptorchidism in these models. CONCLUSIONS Our data support reduced breastfeeding and soy formula feeding as potential risk factors for acquired cryptorchidism. Although additional studies are needed, hormonally active components of breast milk and soy formula could influence the establishment of normal testis position in the first months of life, leading to apparent ascent of testes in childhood. Birth Defects Research (Part A), 2012.
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Affiliation(s)
- Julia Spencer Barthold
- Division of Urology, Alfred I. duPont Hospital for Children, Wilmington, Delaware; Nemours Biomedical Research, Wilmington, Delaware, USA.
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