The effect of quitting water pipe during pregnancy on Anthropometric measurements at birth: a population-based prospective cohort study in South of Iran

Abstract

Background Evidence on health effects of tobacco cessation in pregnancy is mainly restricted to cigarette, while water pipe smoking is more prevalent among women in the Middle-East. The present ‎study aimed to assess the effects of cessation of water pipe during pregnancy on ‎birth anthropometric measures in South of Iran. Methods Data on 1,120 singleton pregnancies (response rate=93.4%) from a population-based prospective cohort study in suburban communities in Bandar Abbas city was used. Birth measures were used according to infant`s vaccination cards. Study subjects were categorized into three subgroups based on water pipe ‎smoking status during pregnancy, including: 1) mothers who never smoke water pipe ‎‎(never smoker); 2)mothers who stopped water pipe during pregnancy and resumed it postpartum (quitters); 3) mothers who continued smoking water pipe regardless ‎of their pregnancy (always smokers). ‎Generalized Linear Models (GLMs) were utilized for the analyses. Results Compared to never smokers, quitting water pipe in pregnancy would decrease mean birthweight by 99.30 ‎grams (β:-99.30, 95%CI:-204.35,-5.75‎); while an additional decrease by 37.83 grams would occur in always smokers (β:-137.13‎;95%CI:-262.21,-‎‎12.05‎). Mean birth length ‎did not significantly differ among the three water pipe groups. Mean head ‎circumference, however, would significantly increase by 0.79 centimeter in always smokers (β:079,95%CI:0.13,1.45). ‎ Conclusion Quitting water pipe during pregnancy had positive effects on infant growth, especially birth weight. Some suggestions are provided including integration of information on health benefits of quitting smoking into routine prenatal healthcare services and development of awareness programs to encourage smokers to quit early in pregnancy.