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Kheirallah KA, Shugaa Addin N, Alolimat MM. Trends of maternal waterpipe, cigarettes, and dual tobacco smoking in Jordan. A decade of lost opportunities. PLoS One 2021; 16:e0253655. [PMID: 34242237 PMCID: PMC8270187 DOI: 10.1371/journal.pone.0253655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. Methods A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Results Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Conclusions Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette–waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.
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Affiliation(s)
- Khalid A. Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- * E-mail:
| | - Nuha Shugaa Addin
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Maan M. Alolimat
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
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Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Triandafilidis Z, Ussher JM, Perz J, Huppatz K. Young Australian women's accounts of smoking and quitting: a qualitative study using visual methods. BMC WOMENS HEALTH 2018; 18:5. [PMID: 29301518 PMCID: PMC5755039 DOI: 10.1186/s12905-017-0500-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
Abstract
Background Although the overall rate of smoking in Australia continues to decline, the rate of decline has begun to slow. Rates of smoking among young women in Australia have been a particular concern, which has led to the development of targeted public health campaigns. Poststructuralist theory has successfully been used in research to explore the way in which young women experience smoking. However, there is an absence of poststructuralist analysis of young women’s experiences of quitting. This study aims to address this gap. Methods We carried out 27 interviews with young Australian women smokers and ex-smokers. Eighteen of those women then participated in a photography activity and follow-up interviews. A Foucauldian discourse analysis of the data was conducted. Results Through our analysis, we identified three discourses: ‘The irresponsibility of smoking: Quitting as responsible’, ‘The difficulties of quitting: Smoking as addictive’, and ‘Making a decision to quit: Smoking as a choice’. In relation to these discourses, participants took up contradictory positions of responsibility and resistance, addiction and agency. Taking up these positions had implications for young women’s subjectivity, and the way they engaged with tobacco controls and cessation support. Conclusions The analysis highlights the complex and contradictory nature of young women’s experiences with smoking and quitting. The study’s findings are considered in relation to the improvement of tobacco control policies and cessation support programmes targeted at young women.
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Affiliation(s)
- Zoi Triandafilidis
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia.
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Kate Huppatz
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
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Xu X, Rao Y, Wang L, Liu S, Guo JJ, Sharma M, Zhao Y. Smoking in pregnancy: a cross-sectional study in China. Tob Induc Dis 2017; 15:35. [PMID: 28747859 PMCID: PMC5525238 DOI: 10.1186/s12971-017-0140-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 07/14/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Findings on smoking among pregnant women were mostly from high income countries and were rarely from China. This study aimed to estimate the prevalence of smoking and its influencing factors among pregnant women living in China. METHODS A cross-sectional analysis was conducted in this study. Data from pregnant women were collected in this study from June to August 2015 from 5 provinces of mainland China. A total of 2345 pregnant women were included in this study, the mean age of the participants was 28.12 years (SD 4.13). RESULTS About 82.9% of smoking women quit smoking after they were pregnant. The prevalence of smoking among pregnant women was 3.8%. Among the participants, 40.0, 30.7, 1.8, 29.9, 0.8, 31.4, 31.2, and 26.7% had husbands, fathers-in-law, mothers-in-law, fathers, mothers, colleagues, friends, and relatives, respectively, who were smokers. Compared with pregnant women of basic education level (junior middle school or below), those of the higher education level (undergraduate or above) were at higher risk of smoking (OR, 5.17; 95% CI, 2.00-13.39). Compared with pregnant women from rural areas, urban pregnant women were less likely to be current smokers (OR, 0.55; 95% CI, 0.32-0.94). Compared with pregnant women whose mothers-in-law did not smoke, those whose mothers-in-law smoked were at higher risk of smoking (OR, 4.67; 95% CI, 1.87-11.70). However, compared with pregnant women whose husband did not smoke, those whose husband smoked were not significantly at higher risk of smoking (OR, 1.12; 95% CI, 0.73-1.73). CONCLUSIONS Most of smoking women quit smoking after they became pregnant. Tailored intervention programs to reduce smoking in pregnant women should focus on those with higher education level, from rural areas, and pregnant women whose mothers-in-law smoke.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, No, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Yunshuang Rao
- School of Nursing, Chongqing Medical University, Chongqing, 400016 China
| | - Lianlian Wang
- The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
- Department of Reproduction Health and Infertility, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
- Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, 400016 China
| | - Sheng Liu
- School of Public Health and Management, Chongqing Medical University, No, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Jeff J. Guo
- Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH 45267 USA
| | - Manoj Sharma
- Department of Behavioral and Environmental Health, Jackson State University, Jackson, 39213 USA
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, No, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
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Massey SH, Bublitz MH, Magee SR, Salisbury A, Niaura RS, Wakschlag LS, Stroud LR. Maternal-fetal attachment differentiates patterns of prenatal smoking and exposure. Addict Behav 2015; 45:51-6. [PMID: 25644587 DOI: 10.1016/j.addbeh.2015.01.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/14/2014] [Accepted: 01/14/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers. METHODS Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers. RESULTS At 30 weeks, pregnancy quitters scored higher on the 'giving of self' subscale compared to persistent smokers (21.6±2.4 versus 19.9±2.9; p=.004). Maternal 'giving of self' also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9±2.9 versus 21.2±2.2; p=.002). Controlling for age, income, unemployment, gravida, and father's smoking status, 'giving of self' differentiated pregnancy quitters from persistent smokers [OR=5.144; 95% C.I. 1.509 - 17.538; B (SE)=1.638 (.626); p=.009]. CONCLUSIONS Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA,; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA.
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
| | - Susanna R Magee
- Department of Family Medicine, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Amy Salisbury
- Department of Pediatrics, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, USA.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
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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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Ussher M, Etter JF, Giatras N, Coleman T. Tobacco withdrawal symptoms and urges to smoke in pregnant versus non-pregnant smokers. Addict Behav 2012; 37:1353-7. [PMID: 22958869 DOI: 10.1016/j.addbeh.2012.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 06/13/2012] [Accepted: 07/18/2012] [Indexed: 11/27/2022]
Abstract
We compared tobacco withdrawal in pregnant and non-pregnant smokers abstaining from smoking for 24h. Female smokers completed an internet-based questionnaire, including the Minnesota Nicotine Withdrawal Scale-Revised (MNWS). They also rated additional withdrawal items and strength of urge to smoke. Consenting women were randomized to either: (i) abstain from smoking for 24h or (ii) smoke as usual. After 24h they rated their withdrawal again. We included a 'smoking as usual' group as we wished to establish that smoking abstinence increased withdrawal symptoms. Two-hundred and seventy-five women completed both the initial and the 24h questionnaire and reported abstaining (n=115, 17% pregnant) or smoking (n=160, 21% pregnant) as requested. Exclusively among abstinent smokers, we compared symptoms for the pregnant and non-pregnant groups. After 24h pregnant women had significantly lower scores than non-pregnant women for the mean MNWS (p=0.004) and for three individual MNWS symptoms (angry, p=0.010; anxious, p=0.048; impatient, p=0.011), with adjustments for baseline cigarette consumption and baseline withdrawal scores. Overall, on the first day of smoking abstinence, pregnant women are likely to report less severe tobacco withdrawal than non-pregnant women.
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Affiliation(s)
- Michael Ussher
- Division of Population Health Sciences and Education, St George's University of London, London SW17 ORE, UK.
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Massey SH, Neiderhiser JM, Shaw DS, Leve LD, Ganiban JM, Reiss D. Maternal self concept as a provider and cessation of substance use during pregnancy. Addict Behav 2012; 37:956-61. [PMID: 22575401 PMCID: PMC3377383 DOI: 10.1016/j.addbeh.2012.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 03/17/2012] [Accepted: 04/10/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Maternal substance use during pregnancy is a common modifiable risk factor for poor birth outcomes, and is associated with long term psychological risks to offspring. As self concept is known to affect substance use behaviors in non-pregnant women, we hypothesized that self concept as a provider may be particularly salient to cessation of use during pregnancy. To isolate psychological processes specific to pregnancy from those associated with the transition to parenthood, we examined birth mothers who made adoption placements participating in the Early Growth and Development Study. METHODS We obtained lifetime and pregnancy substance use history and psychological measures at 3 to 4months postpartum from 693 women recruited from the Northwest, Southwest, and Mid-Atlantic regions of the United States. Life history calendar and computer-assisted personal interviewing methods were used to minimize reporting bias. Using logistic regression, we assessed the association of self concept as an adequate provider with cessation of substance use during pregnancy, controlling for sociodemographic variables, depressive symptoms experienced during pregnancy, past year antisocial behaviors, family history of substance abuse, timing of pregnancy recognition, timing of initiation of prenatal care, and emotional adjustment to the adoption decision. RESULTS More positive self-concept as an adequate provider was independently associated with cessation of substance use and earlier initiation of prenatal care during pregnancy [OR=1.223; 95% C.I. (1.005-1.489); B(SE)=.201(.100)]. Familial substance abuse, depressive symptoms, and antisocial behaviors during pregnancy, were also independent predictors, and more strongly associated with cessation [OR=.531; 95% C.I. (.375-.751); B(SE)=-.634 (.178)], [OR. 940; 95% C.I. (.906-.975); B(SE)=-.062 (.019)], [OR=.961; 95% C.I. (.927-.996); B(SE)=-.040 (.018)]. CONCLUSIONS Enhancing maternal identity as a provider for the fetus during pregnancy, along with treatment of depression, may improve motivation to stop substance use.
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Affiliation(s)
- Suena H. Massey
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW, Washington, DC 20037, U.S.A
| | - Jenae M. Neiderhiser
- Department of Psychology, Pennsylvania State University, 222 Moore Building, University Park, PA 16802, U.S.A
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, 4101 Sennott Square, 3 Floor, Pittsburgh, PA 15260, U.S.A
| | - Leslie D. Leve
- Oregon Social Learning Center, 10 Shelton McMurphey Boulevard, Eugene, OR 97401
| | - Jody M. Ganiban
- Department of Psychology, George Washington University Columbian College of Arts and Sciences, 2125 G Street, NW, Room 308, Washington, D.C., 20052
| | - David Reiss
- Yale Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06519, U.SA
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Semyonov L, Iarocci G, Boccia A, La Torre G. Socioeconomic differences in tobacco smoking in Italy: is there an interaction between variables? ScientificWorldJournal 2012; 2012:286472. [PMID: 22536132 PMCID: PMC3317588 DOI: 10.1100/2012/286472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 11/21/2011] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the influence of sociodemographic factors on smoking habits in Italy and if an interaction exists between these variables. METHODS Data from the national survey "Health Conditions and Healthcare Services Use" in 2005 were used. The independent association between tobacco smoking and sociodemographical variables was assessed using logistic regression analysis. Interactions between variables were investigated calculating the synergism index (SI). RESULTS Sample population consists of 109.829 subjects (over 15 years). 21.9% are current and 21.8% are former smokers. Current smokers are mostly 45-54-years old males, from Central Italy, unemployed, divorced or separated but having a good health status without chronic medical conditions. Ever smokers are mostly 45-54 years old males, from Northeast Italy, unemployed, with chronic conditions. People with a university degree and with a good household income have the lowest OR for both conditions. A synergistic effect was found between marital status and educational level (for ever smokers SI = 1.96; for current smokers SI = 1.67). CONCLUSIONS Smoking is prevalent in lower socioeconomic groups and there is the strong need to increase social, economic and cultural capital in order to reduce it.
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Affiliation(s)
- Leda Semyonov
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena 324, 00181 Rome, Italy
| | - Gianluca Iarocci
- Istituto Superiore per la Protezione e la Ricerca Ambientale (ISPRA), 00144 Rome, Italy
| | - Antonio Boccia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena 324, 00181 Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena 324, 00181 Rome, Italy
- Eleonora Lorillard Spencer Cenci Foundation Rome, Italy
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De Santis M, De Luca C, Mappa I, Quattrocchi T, Angelo L, Cesari E. Smoke, alcohol consumption and illicit drug use in an Italian population of pregnant women. Eur J Obstet Gynecol Reprod Biol 2011; 159:106-10. [PMID: 21831510 DOI: 10.1016/j.ejogrb.2011.07.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 06/27/2011] [Accepted: 07/11/2011] [Indexed: 02/05/2023]
Abstract
OBJECTIVE High-risk behaviours are associated with an increased risk of adverse pregnancy outcomes. Exposure to drugs, infection or radiation is a cause of concern for pregnant women, who contact Teratology Information Services (TIS) to have a counseling but with an accurate medical history is possible to detect additional behavioural risk factors that can significantly interfere with pregnancy outcome. The aim of this study is to describe risk behaviours in a population of Italian women calling our TIS and to identify related maternal factors. STUDY DESIGN Between December 2008 and January 2010 we collected data from 503 pregnant women calling our TIS (Telefono Rosso, Rome). We investigated about smoke, alcohol and abuse substances addiction and we also collected demographic data. RESULTS Of the 503 women consenting to participate 34% were found to have an additional risk marker during the current pregnancy. Within this group were 22.7% (n=119) who reported smoking, the 17.7% (n=89) admitted to drink and 2 women (0.4%) used illicit drugs. In 13.7% of cases (n=69) reason for calling represented an exposure to teratogenic agents. Unmarried status and previous induced abortion represent a risk factor for all high-risk behaviours. Lower education (p<0.001) and use of neurological drugs (p<0.001) are related with cigarette consumption. A lower parity was a risk factor for alcohol assumption (p=0.04). Women with high-risk behaviours tend to be exposed to more than a risk factor. CONCLUSIONS Teratogen Information Services are an important system to identify women with pregnancy risk markers. These services should have the ability to provide risk reduction information to women who smoke cigarettes or with alcohol or drug use. In addition to the phone based information these women may benefit from referral back to their physician for assessment and management of substance use/abuse during pregnancy. Substance abuse risks are often underestimated by pregnant women. Single mothers or women with an history of terminations of pregnancy represents an high-risk population. Physicians should inform their patients about possible risks related to high-risk behaviours during preconception counseling or during the first obstetric visit.
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Affiliation(s)
- Marco De Santis
- Telefono Rosso - Teratology Information Service, Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, Rome, Italy.
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