127 Trends in Smoking in Pregnancy in the Netherlands (2001-2010)

Abstract

Arch Dis Child 2012;97(Suppl 2):A1-A539 A35 Abstracts (95% CI 6.8-16.1%)] were referred to specialized hospitals and 6 [3.5% (95% CI 1.6-7.5%)] discontinued treatment. Conclusion Children with severe pneumonia with SAM could be treated safely and effectively on a day-care basis at established daycare clinics, similar to hospital management, if required logistic support is available. Background and aims Smoking in pregnancy significantly increases the risk of preterm birth and fetal growth restriction. Pregnant women are encouraged to quit smoking. Smoking in general is discouraged by antismoking laws. In the present study, we describe trends in smoking in pregnancy in the Netherlands for 2001-2010. Methods National surveys in 2001, 2002, 2003, 2005, 2007, and 2010. In well baby clinics, questionnaires were handed out to mothers with infants ≤ 6 months. Results Out of a total number of 28,720 questionnaires, 16,358 (57%) were returned. Between 2001 and 2010, prevalence of smoking in pregnancy dropped by half; from 13.0% in 2001 to 6.3% in 2010 (P trend < 0.001). The odds of being a smoker was 6.3 (95%CI 5.3-7.4) for mothers with a low education level, and 3.0 (95% CI 2.5-3.5) for mothers with a medium education level, as compared to mothers with high education level. Independently of their educational level, mothers smoked on average five cigarettes per day while pregnant. TRENDSWe .3% of Dutch pregnant women were smokers, exposing about 11,000 unborn children per year to significantly increased health risks.

Social Disparities in Maternal Smoking during Pregnancy

“…These KiGGS data are largely commensurate with and correspond to the data presented by Scholz et al on the prevalence of maternal smoking during pregnancy which are based on the German perinatal survey (birth cohorts 1995-1997: 23.5 %, 2007-2011: 11.2 %) [56]. The percentage of women who smoke during pregnancy has decreased significantly since the 1990s, not just in Germany but in most westernized countries [39,41,42,45]. Despite this welcome development, there are still certain risk groups where smoking is especially common.…”

“…The KiGGS data also prove for both birth cohorts that children with a low social status are exposed significantly more often to tobacco smoke before they are born than children with a moderate social status, and, in turn, that children with a moderate social status are exposed significantly more often to tobacco smoke in the womb than children with a high social status. This social gradient in maternal smoking behavior was also reported in the overwhelming majority of national [35,48,55] and international studies [37,39,41,42,58]. In a Dutch study started in the period 2009-2011 the prevalence of maternal smoking for pregnant women was 25.4, 11.4 and 2.6 %, respectively, for low, moderate and high social status groups [58], a distribution pattern that was found to be very similar to that for children with low (28.7 %), moderate (11.1 %) or high social status (2.3 %) in the KiGGS birth cohorts of 2003-2012.…”

“…It is the only way to identify risk groups and develop suitable approaches to reduce maternal smoking during pregnancy and to evaluate the efficacy of the approaches used [37,38]. International studies have shown that in most westernized countries a significant percentage of women still smoke during pregnancy, although in many countries the existing data point to a decline in the prevalence of maternal smoking over the last ten to twenty years [37][38][39][40][41][42]. Currently, the percentage of women who smoke during pregnancy is 10.7 % in the USA (2010) [43] [39], 12.5 % in Denmark (2010) [39] and 6.9 % in Sweden (2008) [39].…”

“…Both international and national studies have concurred in showing that there are significant demographic and social differences with regard to the distribution of maternal smoking behavior in pregnancy. Particularly young, poorly educated and socially deprived women are significantly more likely to smoke during pregnancy than older, better educated and socially better-off pregnant women [35,37,41,42,44,50,58]. There are only a few studies on the impact of a migration background on maternal smoking [46,55,58,59].…”

Association Between rs1051730 and Smoking During Pregnancy in Dutch Women

“…Association Between rs1051730 and Smoking During Pregnancy in Dutch Women and the United States 6 and higher prevalence in low-and middleincome countries like Uruguay (18.3%) 7 and Romania (15%). 8 Smoking during pregnancy appears to have decreased steadily in recent years.…”