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Wheeler DC, Boyle J, Barsell DJ, Maguire RL, Dahman B, Murphy SK, Hoyo C, Zhang J, Oliver JA, McClernon J, Fuemmeler BF. Neighborhood Deprivation is Associated with Increased Risk of Prenatal Smoke Exposure. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1078-1089. [PMID: 35179695 PMCID: PMC9385886 DOI: 10.1007/s11121-022-01355-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 02/01/2023]
Abstract
Despite years of advisories against the behavior, smoking among pregnant women remains a persistent public health issue in the USA. Recent estimates suggest that 9.4% of women smoke before pregnancy and 7.1% during pregnancy in the USA. Epidemiological research has attempted to pinpoint individual-level and neighborhood-level factors for smoking during pregnancy, including educational attainment, employment status, housing conditions, poverty, and racial demographics. However, most of these studies have relied upon self-reported measures of smoking, which are subject to reporting bias. To more accurately and objectively assess smoke exposure in mothers during pregnancy, we used Bayesian index models to estimate a neighborhood deprivation index (NDI) for block groups in Durham County, North Carolina, and its association with cotinine, a marker of smoke exposure, in pregnant mothers (n = 887 enrolled 2005-2011). Results showed a significant positive association between NDI and log cotinine (beta = 0.20, 95% credible interval = [0.11, 0.29]) after adjusting for individual covariates (e.g., race/ethnicity and education). The two most important variables in the NDI according to the estimated index weights were percent females without a high school degree and percent Black population. At the individual level, Hispanic and other race/ethnicity were associated with lowered cotinine compared with non-Hispanic Whites. Higher education levels were also associated with lowered cotinine. In summary, our findings provide stronger evidence that the socio-geographic variables of educational attainment and neighborhood racial composition are important factors for smoking and secondhand smoke exposure during pregnancy and can be used to target intervention efforts.
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Affiliation(s)
- David C Wheeler
- Department of Biostatistics, One Capitol Square, Virginia Commonwealth University, 7th Floor, 830 East Main St, Richmond, VA, 23298, USA.
| | - Joseph Boyle
- Department of Biostatistics, One Capitol Square, Virginia Commonwealth University, 7th Floor, 830 East Main St, Richmond, VA, 23298, USA
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA
| | - Rachel L Maguire
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, 27710, USA
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
| | - Bassam Dahman
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
| | - Jim Zhang
- Duke Global Health Institute, Durham, NC, 27708, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, 73104, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, 74136, USA
| | - Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 27701, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, 23298-0032, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, 23298, USA
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Diabelková J, Rimárová K, Urdzík P, Dorko E, Houžvičková A, Andraščíková Š, Kaňuková L, Kluková D, Drabiščák E, Konrádyová N, Škrečková G. Influence of maternal smoking during pregnancy on birth outcomes. Cent Eur J Public Health 2022; 30:S32-S36. [PMID: 35841223 DOI: 10.21101/cejph.a6811] [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: 03/03/2021] [Accepted: 12/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. METHODS We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. RESULTS Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. CONCLUSION Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.
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Affiliation(s)
- Jana Diabelková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Peter Urdzík
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital in Kosice, Kosice, Slovak Republic
| | - Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Andrea Houžvičková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Štefánia Andraščíková
- Department of Midwifery, Faculty of Health Care, University of Presov, Presov, Slovak Republic
| | - Lívia Kaňuková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | | | - Erik Drabiščák
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Nika Konrádyová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Gabriela Škrečková
- Department of Physiotherapy, Faculty of Health Care, University of Presov, Presov, Slovak Republic
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