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Ganapathy D, Tzeli M, Vivilaki V. Midwives: Essential guardians in the climate crisis journey. Eur J Midwifery 2024; 8:EJM-8-22. [PMID: 38779537 PMCID: PMC11110073 DOI: 10.18332/ejm/188196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Deepti Ganapathy
- Centre for Management Communication, Indian Institute of Management, Bangalore, India
| | - Maria Tzeli
- Midwifery Department, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Victoria Vivilaki
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
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HAMUTENYA SELMA, NGHITANWA EMMAMAANO. Practices of pregnant women regarding tobacco and alcohol use during pregnancy at one primary health care clinic in Southern Namibia. J Public Health Afr 2023; 14:2652. [PMID: 38020275 PMCID: PMC10662217 DOI: 10.4081/jphia.2023.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/14/2023] [Indexed: 12/01/2023] Open
Abstract
Tobacco and alcohol use during pregnancy has negative consequences, to the fetus. The study purpose was to investigate the practices of pregnant women regarding the use of tobacco and alcohol during pregnancy. A quantitative research approach with a descriptive, cross-sectional, analytical design was used. The population were all pregnant women aged 18 years and above attending antenatal care at Mariental clinic. Written informed consent was obtained from all respondents prior to data collection. Data was collected from 211 respondents selected through a systematic sampling. Data was analysed using Statistical Package of the Social Sciences version 27. Descriptive statistics were used for frequencies and percentages. Fisher's Exact test at 0.05 alpha level was used to determine the association between variables. The mean age was 28.8 with a standard deviation of 6.9 years. Most participants, 92 (43.6%) were aged between 18 and 24 years. Majority, 186 (88.15%) were in third trimester of pregnancy and 154 (73%) were single. Most 148 (70.14%) respondents have good practices towards alcohol use during pregnancy. Moreover, 190 (90%) of the respondents were classified as having good practices towards tobacco use in pregnancy. Educational levels showed a significant association with practices towards tobacco smoking (P=0.042). The study concluded good practices among pregnant women on alcohol and tobacco smoking during pregnancy. It is recommended that health facilities should introduce awareness campaign on the dangers of alcohol and tobacco use during pregnancy. Moreover, educational materials should be developed in local languages and distributed to community.
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Affiliation(s)
| | - EMMA MAANO NGHITANWA
- Midwifery department, University of Namibia, School of Nursing and Public Health, Windhoek, Namibia
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Tigka M, Metallinou D, Tzeli M, Lykeridou K. Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece during the COVID-19 pandemic. Tob Induc Dis 2023; 21:80. [PMID: 37333502 PMCID: PMC10273827 DOI: 10.18332/tid/166109] [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: 12/16/2022] [Revised: 04/06/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Low-level knowledge of problematic substance use during the perinatal period may lead to numerous adverse outcomes. We sought to determine maternal tobacco, alcohol and caffeine consumption during the perinatal period during the COVID-19 pandemic. METHODS This prospective cohort study recruited women from five Greek maternity hospitals between January and May 2020. Data were collected with a structured questionnaire initially completed by postpartum women during their hospitalization and re-administered via telephone interview in the first, third and sixth month postpartum. RESULTS The study sample consisted of 283 women. Smoking rates decreased during pregnancy (12.4%) compared to the pre-pregnancy period (32.9%, p<0.001) and during lactation (5.6%) compared to the antenatal period (p<0.001). The smoking rate increased again after breastfeeding cessation (16.9%) compared to the rate during lactation (p<0.001), but remained lower than the pre-pregnancy rate (p=0.008). Only 1.4% of the women reported breastfeeding cessation due to smoking, whereas those who smoked more during pregnancy were more likely to cease breastfeeding (OR=1.24; 95% CI: 1.05-1.48, p=0.012). Regarding alcohol consumption, it was significantly lower during pregnancy (5.7%), lactation (5.5%) and after breastfeeding cessation (5.2%) compared to the pre-pregnancy period (21.9%, p<0.001 for all correlations). Women who consumed alcohol during lactation were less likely to wean (OR=0.21; 95% CI: 0.05-0.83, p=0.027). Caffeine intake decreased during pregnancy compared to preconception period (p<0.001), while in lactating women it remained at low rates until the 3rd month of follow-up. Caffeine consumption at one month postpartum (β=0.09; SE=0.04, p=0.045) was positively associated with longer duration of breastfeeding. CONCLUSIONS Tobacco, alcohol and caffeine consumption decreased in the perinatal period compared to the preconception period. The pandemic may have contributed to the downtrend in smoking and alcohol consumption due to COVID-related restrictions and fear of potential illness. Nevertheless, smoking was associated with reduced duration of breastfeeding and breastfeeding cessation.
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Affiliation(s)
- Maria Tigka
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
- Department of Obstetric Emergency, General and Maternity Hospital 'Helena Venizelou', Athens, Greece
| | - Dimitra Metallinou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Maria Tzeli
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
| | - Katerina Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece
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Spyrakou E, Magriplis E, Benetou V, Zampelas A. Factors Associated with Breastfeeding Initiation and Duration in Greece: Data from the Hellenic National Nutrition and Health Survey. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111773. [PMID: 36421222 PMCID: PMC9688813 DOI: 10.3390/children9111773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022]
Abstract
Despite its well-documented benefits, breastfeeding rates and duration worldwide do not meet the recommended goals set by the World Health Organization. Data on infant feeding, socio-demographic, lifestyle and perinatal factors were used from 490 mothers (and 958 children), participants at the Hellenic National Nutrition and Health Survey between 2013−2015. Clustered multiple logistic regression and multilevel mixed-model regression analyses were performed to identify factors associated with breastfeeding initiation and duration, respectively. Maternal lower education [Odds Ratio (OR): 2.29, 95% Confidence intervals (95% CI): 1.30−4.04; p = 0.004], smoking during pregnancy (OR: 3.08, 95% CI: 1.64−5.77; p < 0.001), caesarean section (OR = 3.26, 95% CI: 1.83−5.83; p < 0.001), prematurity (OR = 2.74, 95% CI: 1.40−5.37; p = 0.003) and higher birth order (OR = 1.30, 95% CI: 1.04−1.62; p = 0.020) were associated with increased odds of not initiating breastfeeding. Living in rural areas [beta coefficient b = −27.93, p = 0.043], smoking during pregnancy (b = −64.47, p < 0.001), caesarean section (b = −28.76, p = 0.046) and prematurity (b = −46.67, p = 0.048) were significantly associated with shorter breastfeeding duration. Children born chronologically closer to the survey were more likely to breastfeed and for longer periods. Educational promotion and enhancement of breastfeeding awareness that account for maternal exposures are required. Prevention of prematurity and avoidance of unnecessary caesarean section is crucial, while additional breastfeeding support is needed when preterm birth occurs, or caesarean section cannot be avoided.
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Affiliation(s)
- Efthimia Spyrakou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece
- Correspondence:
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
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Suzuki M, Wakayama R, Yamagata Z, Suzuki K. Effect of maternal smoking during pregnancy on gestational
weight gain and birthweight: A stratified analysis by
pregestational weight status. Tob Induc Dis 2022; 20:10. [PMID: 35125993 PMCID: PMC8796850 DOI: 10.18332/tid/143952] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
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Affiliation(s)
- Miho Suzuki
- Nagoya Bunri Nutrition College, Nagoya, Japan
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Rei Wakayama
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Graduate School of Medical Science, University of Yamanashi, Chuo, Japan
| | - Kohta Suzuki
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
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Diamanti A, Galiatsatou A, Sarantaki A, Katsaounou P, Varnakioti D, Lykeridou A. Barriers to Smoking Cessation and Characteristics of Pregnant Smokers in Greece. MAEDICA 2021; 16:405-414. [PMID: 34925595 PMCID: PMC8643564 DOI: 10.26574/maedica.2021.16.3.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: Nicotine addiction and the inability of a large part of pregnant smokers to quit is one of the main preventable causes of morbidity and mortality during the perinatal period. The aim of this study is to investigate nicotine dependence and overall smoking habits of pregnant smokers and to possibly correlate them with smokers' social and demographic characteristics. Materials and methods: One hundred and fourteen pregnant smokers answered an electronic questionnaire consisting of 59 questions, which was divided into six sections. The questionnaires were filled out by participants from many regions of Greece and Cyprus. Results:Before their pregnancy, women smoked 19 cigarettes per day on average, while during their pregnancy they dropped to eight cigarettes per day; 65.8% of respondents stated that their husband smoked, while 58.8% answered that they had been exposed to secondhand smoke; 13.2% of pregnant smokers stated that they had had depression at some point in their lives and 14.9% reported having undergone domestic violence; 55.3% of respondents acknowledged that smoking was responsible for a variety of adverse effects to the fetus; and 97.4% of pregnant women did not follow a smoking cessation counseling program, compared to just 2.6% who did. Conclusions:The pregnant smokers in our study did not have appropriate information about the available smoking cessation services, which were not generally considered to be useful for them, and consequently they did not utilize cessation assistance. The resistance towards quitting smoking, which was observed in the sample, may also be attributed to the lack of specialized smoking cessation services in maternity hospitals in Greece.
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Affiliation(s)
- Athina Diamanti
- Department of Midwifery, University of West Attica, Egaleo, Greece
| | | | | | - Paraskevi Katsaounou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
Smoking during pregnancy has negative effects on both maternal and fetal health. One of these negative maternal effects is the potential for depression. A high rate of cigarette smoking in pregnancy is an important public health issue since it affects not only the pregnant woman but also the newborn and its healthy development. The aim of this study is to investigate the relationship between smoking, influencing factors, and depression prevalence in pregnant Syrian refugees and pregnant citizens of the Republic of Turkey (TR). Pregnant citizens in the TR and pregnant Syrian refugees who were registered at health centers between 15.04.2017 and 15.10.2017 in the border city of Ceylanpınar in the Province of Şanlıurfa in Syria were visited in their living areas in the district center and at a tent village, respectively. A total of 414 pregnant women agreed to participate in the study and were included in the survey. To collect data for the cross-sectional study, a sociodemographic and pregnancy characteristics questionnaire was used, in addition to the Fageström Test for Nicotine Dependence (FTND) and the Beck Depression Inventory (BDI). The rate of smoking in all pregnant women was determined to be 49.3% (n = 204) before pregnancy and 37.9% (n = 157) during pregnancy. A statistically significant difference was found between age groups and educational status in relation to smoking status (p = 0.005, p = 0.001). There was also a statistically significant difference between the smoking status of pregnant women and that of their partners and family members (p = 0.001, p = 0.002). The percentage of pregnant women who were passive smokers was 80.2% (n = 332), and a statistically significant difference was found between passive smoking and smoking status (Fisher; 0.000). The presence of risk for depression was detected in 49.8% (n = 206) of all pregnant women surveyed; the rate of depression risk was 50.5% (n = 104) in pregnant TR citizens and 49.5% (n = 102) in pregnant refugees, with no significant difference between the two groups. There was a statistically significant difference between smoking status in pregnancy and the presence of depression risk (p = 0.001). 32.5% of pregnant women were highly nicotine dependent. A moderate positive correlation was determined between the FTND and BDI scores of pregnant women (r = 0.346; p = 0.001). It was found that one-third of all pregnant women smoked and that one of every two showed a risk for depression. A statistically significant correlation was found between smoking status and risk for depression. No statistically significant difference was determined between the two groups, despite high levels of smoking, nicotine dependence, and depression in both. These data suggest the need to develop new preventive strategies in regard to smoking among pregnant women.
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Skalis G, Archontakis S, Thomopoulos C, Andrianopoulou I, Papazachou O, Vamvakou G, Aznaouridis K, Katsi V, Makris T. A single-center, prospective, observational study on maternal smoking during pregnancy in Greece: The HELENA study. Tob Prev Cessat 2021; 7:16. [PMID: 33644498 PMCID: PMC7908060 DOI: 10.18332/tpc/131824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 11/28/2020] [Accepted: 12/19/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The unequivocal association between exposure to smoke and numerous complications of pregnancy, demonstrated in the last decades, has led to a significant decrease of smoking rates in pregnancy. The aim of the present study was to determine the prevalence of maternal smoking and to elucidate factors predisposing to it among pregnant women in Athens, Greece. METHODS A population of 1700 pregnant women (mean age: 31.2±5.5 years) who visited consecutively the Cardiology Department of Helena Venizelou Maternity Hospital in Athens, Greece, between September 2016 and August 2017, was prospectively analyzed. Data regarding changes in the future mother’s smoking habit as well as different sociodemographic factors potentially related to these changes were recorded. RESULTS Of the 1700 participants, 704 (41.4%) were smokers, and of those 52.4% quit smoking after knowledge of their pregnancy status. The overall prevalence of smoking in pregnancy was 19.7%. Prevalence was higher in women who were aged <20 years (p=0.038), were multipara (p=0.032), had ≤12 years of education (p=0.044) and had a partner who was a smoker (p=0.047). Women aged ≤20 years were more likely to be persistent smokers at the beginning of pregnancy and demonstrated a higher prevalence of smoking during pregnancy (42.2% vs 19.7% in the overall study population). CONCLUSIONS Our data demonstrate that maternal smoking during pregnancy still remains a major public health issue in Greece with a prevalence higher than most other industrialized countries.
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Affiliation(s)
- George Skalis
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Stefanos Archontakis
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Costas Thomopoulos
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Iliana Andrianopoulou
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Ourania Papazachou
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Georgia Vamvakou
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
| | - Konstantinos Aznaouridis
- First Cardiology Department, Hippokration General Hospital, University of Athens, Athens, Greece
| | - Vasiliki Katsi
- First Cardiology Department, Hippokration General Hospital, University of Athens, Athens, Greece
| | - Thomas Makris
- Department of Cardiology, Helena Venizelou General & Maternity Hospital, Athens, Greece
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Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103744. [PMID: 32466270 PMCID: PMC7277525 DOI: 10.3390/ijerph17103744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/29/2023]
Abstract
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants' health.
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Diamanti A, Papadakis S, Schoretsaniti S, Rovina N, Vivilaki V, Gratziou C, Katsaounou PA. Smoking cessation in pregnancy: An update for maternity care practitioners. Tob Induc Dis 2019; 17:57. [PMID: 31582946 PMCID: PMC6770622 DOI: 10.18332/tid/109906] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/10/2019] [Accepted: 06/06/2019] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION This paper provides an up-to-date summary of the effects of smoking in pregnancy as well as challenges and best practices for supporting smoking cessation in maternity care settings. METHODS We conducted a qualitative review of published peer reviewed and grey literature. RESULTS There is strong evidence of the effects of maternal tobacco use and secondhand smoke exposure on adverse pregnancy outcomes. Tobacco use is the leading preventable cause of miscarriage, stillbirth and neonatal deaths, and evidence has shown that health effects extend into childhood. Women who smoke should be supported with quitting as early as possible in pregnancy and there are benefits of quitting before the 15th week of pregnancy. There are a variety of factors that are associated with tobacco use in pregnancy (socioeconomic status, nicotine addiction, unsupportive partner, stress, mental health illness etc.). Clinical-trial evidence has found counseling, when delivered in sufficient intensity, significantly increases cessation rates among pregnant women. There is evidence that the use of nicotine replacement therapy (NRT) may increase cessation rates, and, relative to continued smoking, the use of NRT is considered safer than continued smoking. The majority of women who smoke during pregnancy will require support throughout their pregnancy, delivered either by a trained maternity care provider or via referral to a specialized hospital or community quit-smoking service. The 5As (Ask, Advise, Assess, Assist, Arrange) approach is recommended for organizing screening and treatment in maternity care settings. Additionally, supporting smoking cessation in the postpartum period should also be a priority as relapse rates are high. CONCLUSIONS There have been several recent updates to clinical practice regarding the treatment of tobacco use in pregnancy. It is important for the latest guidance to be put into practice, in all maternity care settings, in order to decrease rates of smoking in pregnancy and improve pregnancy outcomes.
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Affiliation(s)
- Athina Diamanti
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Midwifery, University of West Attica, Athens, Greece
| | - Sophia Papadakis
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Sotiria Schoretsaniti
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikoletta Rovina
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- 1st Department of Respiratory Medicine, ‘Sotiria’ Chest Disease Hospital, Athens, Greece
| | | | - Christina Gratziou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Evgenidio Hospital, Athens, Greece
| | - Paraskevi A. Katsaounou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- First ICU, Evangelismos Hospital, Athens, Greece
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Balázs P, Grenczer A, Rákóczi I, Foley KL. Continued smoking versus spontaneous quitting among pregnant women living in a high risk environment. Cent Eur J Public Health 2019; 26:164-170. [PMID: 30419616 DOI: 10.21101/cejph.a5048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES In Hungary, 37% of women living in poverty were smokers in 2012. There are no valid data of pregnant women's spontaneous smoking cessation. METHODS Our retrospective cohort study (2009-2012) targeted the most underdeveloped regions with an estimated 6-8.5% of Roma population. The sample (N = 12,552) represented 76% of the target population i.e. women in four counties in a year delivering live born babies. Chi-square probe and multivariable logistic regression model (p < 0.05) were used to assess relationship between socio-demographic characteristics and spontaneous cessation. RESULTS Prior to pregnancy, the overall smoking rate was 36.8%. That of women in deep poverty and Roma was 49.7% and 51.1%, respectively. 70.3% of smokers continued smoking during the pregnancy. Among them 80.6% lived in deep poverty. Spontaneous quitting rate was 23.0%. Factors correlated with continued smoking included being Roma (OR = 1.95), undereducated (OR = 2.66), living in homes lacking amenities (OR = 1.48), and having regularly smoking partner (OR = 2.07). Cessation was promoted by younger age (≤ 18 years) (OR = 0.18), being married (OR = 0.50), and the first pregnancy. CONCLUSIONS Tailored cessation programmes are needed for Roma, older, low-income, and multiparous women who are less likely to quit on their own. Engaging husbands/partners is essential to reduce smoking among pregnant women and second-hand smoke exposure.
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Affiliation(s)
- Peter Balázs
- Institute of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Andrea Grenczer
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | - Kristie L Foley
- Wake Forest University Medical School, Comprehensive Cancer Center, Winston-Salem, NC, USA
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Mahmoodabad SSM, Karimiankakolaki Z, Kazemi A, Mohammadi NK, Fallahzadeh H. Exposure to secondhand smoke in Iranian pregnant women at home and the related factors. Tob Prev Cessat 2019; 5:7. [PMID: 32411872 PMCID: PMC7205101 DOI: 10.18332/tpc/104435] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/03/2019] [Accepted: 02/15/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Fetus health is of high importance in pregnant women and exposure to secondhand smoke (SHS) endangers maternal and fetal health. Therefore, in this study we examined the prevalence of exposure to SHS in pregnant women at home and the related factors. METHODS This cross-sectional study was conducted with 255 pregnant women who were referred to the Isfahan health care center from July to September 2018. A questionnaire that was designed by the research team was applied to collect data about the participants' prevalence of exposure, attitude-emotional dimension, perceived susceptibility, perceived severity, and perceived barriers. The questionnaire used was self-administered. The validity and reliability of the questionnaire were confirmed by a panel of experts. Cronbach's alpha of attitude-emotional dimension, perceived susceptibility, perceived severity, and perceived barriers were also calculated as 0.81, 0.91, 0.92, and 0.89, respectively. Statistically significant differences were examined using chi-squared test and Mann-Whitney test. RESULTS We found that the prevalence of exposure to SHS in pregnant women was 23.1%. The age of the husband (p=0.041), education level of the smoking husband (p=0.005), the education level of the pregnant woman (p=0.002), employment status of husband (p=0.010), and whether the pregnancy was planned (p=0.010) had significant association with the participant prevalence of exposure to SHS. Thus, older age of husbands, lower education levels of husbands and wives, unwanted pregnancies, and unemployment of husbands resulted in higher exposure to SHS. The mean scores of knowledge and perceptions were lower in women exposed to smoke than in non-exposed women (p<0.05). CONCLUSIONS The rate of SHS exposure was high in pregnant women. The knowledge and perception scores of exposed women to SHS were lower than those of non-exposed women. Low levels of education of husbands and women, unemployment and higher age of husbands, and unwanted pregnancies were considered as health risk factors. Therefore, effective training programs should be designed to educate pregnant women and their husbands.
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Affiliation(s)
- Seyed Saeed Mazloomy Mahmoodabad
- Social Determinants of Health Research Center, Department οf Health Education and Promotion, School οf Public Health, Shahid Sadoughi University οf Medical Sciences, Yazd, Iran
| | - Zohreh Karimiankakolaki
- Social Determinants of Health Research Center, Department οf Health Education and Promotion, School οf Public Health, Shahid Sadoughi University οf Medical Sciences, Yazd, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Hossein Fallahzadeh
- Department of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Roigé-Castellví J, Murphy M, Hernández-Martínez C, Solé-Navais P, Cavallé-Busquets P, Fernández-Ballart J, Ballesteros M, Canals J. The effect of prenatal smoke exposure on child neuropsychological function: a prospective mother-child cohort study. J Reprod Infant Psychol 2019; 38:25-37. [PMID: 30777448 DOI: 10.1080/02646838.2019.1580350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To study prospectively the effect of prenatal smoke exposure (PSE) on child neuropsychological function and intelligence quotient (IQ).Background: PSE has been associated with adverse effects on child neurodevelopment. However, some studies reported that these associations disappear after adjustment for potential confounders.Methods: A cohortof 248 mothers-child dyad was followed from the first trimester of pregnancy until children were 7.5 years old. PSE was recorded during pregnancy by questionnaire and plasma cotinine. The Wechsler Intelligence Scale for Children, the Neuropsychological Assessment of Executive Functions for Children (ENFEN) and the School Neuropsychological Maturity Questionnaire were administered at 7.5 years of age. The effect of PSE on child IQ and neuropsychological function was assessed with ANCOVA, adjusting for obstetric, neonatal and sociodemographic factors.Results: Children whose mothers smoked throughout pregnancy scored lower in interference (ENFEN) compared to unexposed children (F = 4.1; p = .008). The results showed no differences in other executive functions, verbal and visual memory and IQ between the PSE groups.Conclusion: PSE had little effect on child neuropsychological outcome and was limited to mental flexibility. Nevertheless, these findings support further efforts aimed at encouraging mothers to quit smoking in pregnancy.
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Affiliation(s)
- Joana Roigé-Castellví
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Michelle Murphy
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, URV, IISPV, Reus, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Carlos III, Madrid, Spain
| | - Carmen Hernández-Martínez
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Pol Solé-Navais
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, URV, IISPV, Reus, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Carlos III, Madrid, Spain
| | - Pere Cavallé-Busquets
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Carlos III, Madrid, Spain.,Area of Obstetrics and Gynecology, Universitat Rovira i Virgili and Hospital Universitari Sant Joan, Reus, Spain
| | - Joan Fernández-Ballart
- Area of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, URV, IISPV, Reus, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto Carlos III, Madrid, Spain
| | - Mónica Ballesteros
- Area of Obstetrics and Gynecology, Universitat Rovira i Virgili and Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Josefa Canals
- Centre de Recerca en Avaluació i Mesura de la Conducta (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
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14
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Zakarya R, Adcock I, Oliver BG. Epigenetic impacts of maternal tobacco and e-vapour exposure on the offspring lung. Clin Epigenetics 2019; 11:32. [PMID: 30782202 PMCID: PMC6381655 DOI: 10.1186/s13148-019-0631-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/11/2019] [Indexed: 12/15/2022] Open
Abstract
In utero exposure to tobacco products, whether maternal or environmental, have harmful effects on first neonatal and later adult respiratory outcomes. These effects have been shown to persist across subsequent generations, regardless of the offsprings' smoking habits. Established epigenetic modifications induced by in utero exposure are postulated as the mechanism underlying the inherited poor respiratory outcomes. As e-cigarette use is on the rise, their potential to induce similar functional respiratory deficits underpinned by an alteration in the foetal epigenome needs to be explored. This review will focus on the functional and epigenetic impact of in utero exposure to maternal cigarette smoke, maternal environmental tobacco smoke, environmental tobacco smoke and e-cigarette vapour on foetal respiratory outcomes.
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Affiliation(s)
- Razia Zakarya
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
- School of Life Sciences, University of Technology Sydney, Sydney, Australia
| | - Ian Adcock
- Airway Diseases Section, National Heart and Lung Institute, Imperial College London, London, UK
- Biomedical Research Unit, Section of Respiratory Diseases, Royal Brompton and Harefield NHS Trust, London, UK
| | - Brian G Oliver
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.
- School of Life Sciences, University of Technology Sydney, Sydney, Australia.
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15
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Suzuki D, Wariki WMV, Suto M, Yamaji N, Takemoto Y, Rahman MM, Ota E. Association of secondhand smoke and depressive symptoms in nonsmoking pregnant Women: A systematic review and meta-analysis. J Affect Disord 2019; 245:918-927. [PMID: 30699877 DOI: 10.1016/j.jad.2018.11.048] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 09/20/2018] [Accepted: 11/03/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Globally about 30% of adult women and 40% of children are exposed to secondhand smoke (SHS) from active smokers. SHS exposure of pregnant women has been associated with postpartum depression. Unexposed women in pregnancy had lower rates of postpartum depression than women exposed to SHS. This systematic review aimed to determine the association of depressive symptoms and exposure to SHS in nonsmoking pregnant women. METHOD The case-controlled, cross-sectional, and cohort studies with a comparison group were included. Studies including women who had smoking history during pregnancy were excluded. The comprehensive electronic databases, CINAHL, EMBASE, and Medline were searched. RESULT Of the 2777 records screened, seven studies were included in the review for data extraction. The bias of studies was assessed using the RoBANS. We synthesized two studies that showed depressive symptoms at any time during pregnancy and postpartum significantly increased (ORs = 1.77 [95% CI = 1.12 - 2.79]; p = 0.01; I2 = 28%, 4103 women, two studies), and significantly increased the odds of antenatal suicidal ideation in SHS exposed women (ORs = 1.75 [95% CI = 1.14 - 2.70]; p = 0.01; I2 = 51%, 2670 women, two studies). Lack of studies from counties with the highest smoking rates was a limitation. CONCLUSIONS SHS exposure during pregnancy showed a significant increase in the odds of depressive symptoms. Furthermore, research is required to clarify to association between SHS and depression.
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Affiliation(s)
- Daichi Suzuki
- Josai International University, Faculty of Nursing, Department of Nursing, 1 Gumyo, Togane-shi, Chiba 2838555, Japan.
| | - Windy M V Wariki
- Sam Ratulangi University, Faculty of Medicine, JL. Kampus UNSRAT, Bahu, Kleak, Malalayang, Kota Manado, Sulawesi Utara 95115, Indonesia.
| | - Maiko Suto
- St. Luke's International University, Graduate School of Nursing Science, Global Health Nursing, 10-1 Akashi-cho, Chuo-ku, Tokyo 1040044, Japan; Department of Health Policy, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 1578535, Japan.
| | - Noyuri Yamaji
- St. Luke's International University, Graduate School of Nursing Science, Global Health Nursing, 10-1 Akashi-cho, Chuo-ku, Tokyo 1040044, Japan.
| | - Yo Takemoto
- Juntendo University, Department of Obstetrics and Gynecology, 2-1-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan.
| | - Md Mosfequr Rahman
- University of Rajshahi, Department of Population Science and Human Resource Development, Rajshahi 6205, Bangladesh.
| | - Erika Ota
- St. Luke's International University, Graduate School of Nursing Science, Global Health Nursing, 10-1 Akashi-cho, Chuo-ku, Tokyo 1040044, Japan.
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16
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Loukopoulou AN, Vardavas CI, Farmakides G, Rosolymos C, Chrelias C, Tzatzarakis M, Tsatsakis A, Myridakis A, Lyberi M, Behrakis PK. Counselling for smoking cessation during pregnancy reduces tobacco-specific nitrosamine (NNAL) concentrations: A randomized controlled trial. Eur J Midwifery 2018; 2:14. [PMID: 33537575 PMCID: PMC7846038 DOI: 10.18332/ejm/99546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/25/2018] [Accepted: 11/03/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking cessation during pregnancy is beneficial to both the mother and child. Our objective was to assess if an intensive smoking cessation intervention for pregnant women increases: a) rates of smoking cessation, and b) reduces exposure to tobacco-specific carcinogens during pregnancy. METHODS A two-group single-blinded parallel randomized controlled trial (RCT) was conducted involving 84 pregnant smokers in either a high intensity (n=42) or minimal contact control group (n=42). Women assigned to the high intensity smoking cessation intervention group received a single 30-minute behavioural counselling session and a tailored self-help booklet. The primary outcome measures were: 7-day point prevalence abstinence measured by selfreport and urine cotinine levels, and maternal tobacco specific carcinogens nitrosamine (NNAL) urine concentrations assessed at 32 weeks of gestation. RESULTS A significantly greater percentage of pregnant smokers quit smoking in the high intensity group compared to the low intensity control group (45.2% vs 21.4%; p=0.001). A significant decrease in urine cotinine concentrations was documented in the experimental group (-140.74 ± 361.70 ng/mL; p=0.004), with no significant decrease documented in the control group. A significant decrease in NNAL levels was also documented in the experimental group (158.17 ± 145.03 pg/mL before, 86.43 ± 112.54 pg/mL after; p=0.032) with no significant changes in the control group. CONCLUSIONS The high intensity intervention tested resulted in significantly greater cessation rates. Intensive smoking cessation interventions can be effective in reducing fetal exposure to NNAL. This is the first trial to report on NNAL tobacco-specific carcinogen concentrations before and after an intervention for smoking cessation during pregnancy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01210118. ABBREVIATIONS 5Αs: ask, advise, asses, assist, arrange; GHQ: general health questionnaire; ANOVA: analysis of variance; RCT: randomized control trials; NNAL: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.
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Affiliation(s)
| | - Constantine I Vardavas
- George D. Behrakis Research Lab, Hellenic Cancer Society, Athens, Greece
- Institute of Public Health, American College of Greece, Athens, Greece
| | | | | | - Charalambos Chrelias
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Maternity Unit, Attikon Hospital, Athens, Greece
| | - Manolis Tzatzarakis
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
| | - Aristeidis Tsatsakis
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
| | - Antonis Myridakis
- Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece
- Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, United Kingdom
| | - Maria Lyberi
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis K Behrakis
- George D. Behrakis Research Lab, Hellenic Cancer Society, Athens, Greece
- Institute of Public Health, American College of Greece, Athens, Greece
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17
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Song C, Li W, Leng J, Wang L, Li W, Shi F, Liu G, Zhou J, Yang X. Passive smoking and postpartum depression among Chinese women: A prospective cohort study in Tianjin, China. Women Health 2018; 59:281-293. [PMID: 29924720 DOI: 10.1080/03630242.2018.1478365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Smoking has been associated with depression in the general population. Whether passive smoking is also associated with postpartum depression (PPD) is uncertain. From 2010 to 2012, we recruited 8,842 pregnant women in Tianjin, China. The mainland Chinese version of the Edinburgh Postnatal Depression Scale was used to evaluate postpartum depressive symptoms after birth, with a score of >9 defining PPD. Data were collected using specially designed questionnaires or data from the electronic database of Tianjin Maternal and Child Health Information System. Odds ratios (OR) and 95 percent confidence intervals (CI) were obtained for the association of smoking status with PPD using binary logistic regression. Passive smoke exposure rates before and during pregnancy were 40.9 percent and 52.1 percent, respectively. A total of 8.5% (n = 747) of participants had PPD. Compared with those not exposed, women passively exposed to smoke before and during pregnancy had higher odds of PPD (before pregnancy: OR: 1.24, 95 percent CI: 1.03-1.50; during pregnancy: OR: 1.43, 95 percent CI: 1.16-1.77) after adjustment for confounding factors. Passive smoking before and during pregnancy were associated with PPD in Chinese women. Reducing passive smoke exposure may reduce PPD in Chinese women; further longitudinal studies are warranted to replicate these findings.
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Affiliation(s)
- Chunhua Song
- a Department of Epidemiology and Biostatistics, School of Public Health , Tianjin Medical University , Tianjin , China.,b Center for Disease Control and Prevention of Tianjin Economic-Technological Development Area (TEDA) , Tianjin , China
| | - Wei Li
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Junhong Leng
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Leishen Wang
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Weiqin Li
- c Tianjin Women and Children's Health Center , Tianjin , China
| | - Fenglan Shi
- d Tianjin He Ping Women and Children's Health Centre , Tianjin , China
| | - Guifeng Liu
- e Tianjin Nan Kai Women and Children's Health Centre , Tianjin , China
| | - Juan Zhou
- f Tianjin Hong Qiao Disease Control and Prevention Center , Tianjin , China
| | - Xilin Yang
- a Department of Epidemiology and Biostatistics, School of Public Health , Tianjin Medical University , Tianjin , China
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18
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di Giacomo E, Colmegna F, Pescatore F, Aspesi F, Fotiadou M, Clerici M. The burden of personality disorders on the DSM 5 addiction to tobacco during pregnancy. Compr Psychiatry 2018; 84:101-105. [PMID: 29729554 DOI: 10.1016/j.comppsych.2018.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tobacco smoking is a major health concern. Many women smoke during their reproductive years, some of them during their pregnancy. Adverse outcomes for the newborns physical health are well recognized, while the influence on their mental health is still under investigation. We aim at demonstrating the contribution of maternal personality disorders in maintaining addiction to tobacco during pregnancy, to underline their role and the need of their detection as a preventive effort. METHOD 150 women, consecutively admitted to the Perinatal Psychiatric Outpatient Department were tested with the SCID II, CTQ, WHOQOL-BREF, EPDS, BDI and BAI. Tobacco use disorder was attested with the fulfillment of DSM 5 criteria. RESULTS 46% (n = 69) of the sample was affected by at least one personality disorder ("PD+"). "PD+" showed a significant higher rate of pregnant women addicted to tobacco (p = 0.021). The average number of cigarettes per day was notably distinct, since patients affected by "NPD" smokes twice the amount compared to "PD-" and "other PDs", while those affected by Borderline PD has a halfway consumption (7.20 ± 5.54 vs 3.37 ± 4.62 vs 3 ± 3.39 vs 5.50 ± 4.10). ANOVA and POST HOC showed a significance between "NPD" and "other PDs" (p = 0.035), and "other PDs" has significantly the highest rate of active smokers. CONCLUSION Personality disorders demonstrate to be a clear contributor in supporting addiction to tobacco during pregnancy. Short and long term health and mental consequences attested in the newborn, encourage awareness in detecting tobacco dependency during this sensitive period. The inclusion of personality evaluation and management in tobacco dependency treatment programs is strictly encouraged to boost their efficiency and increase tobacco abstinence.
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Affiliation(s)
- Ester di Giacomo
- PhD program in Neuroscience, Doctorate School of the University of Milano-Bicocca, Italy; School of Medicine and Surgery-University of Milano Bicocca, Italy; Psychiatric Department-ASST Monza, Italy.
| | | | | | | | - Maria Fotiadou
- Female Medium Secure Forensic Service, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Massimo Clerici
- School of Medicine and Surgery-University of Milano Bicocca, Italy; Psychiatric Department-ASST Monza, Italy
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19
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Tsakiridis I, Mamopoulos A, Papazisis G, Petousis S, Liozidou A, Athanasiadis A, Dagklis T. Prevalence of smoking during pregnancy and associated risk factors: a cross-sectional study in Northern Greece. Eur J Public Health 2018; 28:321-325. [DOI: 10.1093/eurpub/cky004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stamatios Petousis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Liozidou
- Department of Psychology, Faculty of Human Sciences, Athens Metropolitan College, Athens, Greece
| | - Apostolos Athanasiadis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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McEvoy CT, Spindel ER. Pulmonary Effects of Maternal Smoking on the Fetus and Child: Effects on Lung Development, Respiratory Morbidities, and Life Long Lung Health. Paediatr Respir Rev 2017; 21:27-33. [PMID: 27639458 PMCID: PMC5303131 DOI: 10.1016/j.prrv.2016.08.005] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/11/2016] [Indexed: 02/07/2023]
Abstract
Maternal smoking during pregnancy is the largest preventable cause of abnormal in-utero lung development. Despite well known risks, rates of smoking during pregnancy have only slightly decreased over the last ten years, with rates varying from 5-40% worldwide resulting in tens of millions of fetal exposures. Despite multiple approaches to smoking cessation about 50% of smokers will continue to smoke during pregnancy. Maternal genotype plays an important role in the likelihood of continued smoking during pregnancy and the degree to which maternal smoking will affect the fetus. The primary effects of maternal smoking on offspring lung function and health are decreases in forced expiratory flows, decreased passive respiratory compliance, increased hospitalization for respiratory infections, and an increased prevalence of childhood wheeze and asthma. Nicotine appears to be the responsible component of tobacco smoke that affects lung development, and some of the effects of maternal smoking on lung development can be prevented by supplemental vitamin C. Because nicotine is the key agent for affecting lung development, e-cigarette usage during pregnancy is likely to be as dangerous to fetal lung development as is maternal smoking.
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Affiliation(s)
- Cindy T. McEvoy
- Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines St, CDRC-P, Portland, OR 97239
| | - Eliot R. Spindel
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, , 503-634-9364
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21
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Yazici AB, Uslu Yuvaci H, Yazici E, Halimoglu Caliskan E, Cevrioglu AS, Erol A. Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit? Int J Womens Health 2016; 8:549-556. [PMID: 27785104 PMCID: PMC5063552 DOI: 10.2147/ijwh.s116170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant. Aim The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy. Method This study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy. Results The substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol. Conclusion Cigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.
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Affiliation(s)
| | | | - Esra Yazici
- Faculty of Medicine, Department of Psychiatry
| | - Ebru Halimoglu Caliskan
- Department of Obstetrics and Gynaecology, Training and Research Hospital, Sakarya University, Sakarya, Turkey
| | | | - Atila Erol
- Faculty of Medicine, Department of Psychiatry
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