The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes

Cnattingius, Sven

doi:10.1080/14622200410001669187

Cited by 969 publications

(965 citation statements)

References 144 publications

(140 reference statements)

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“…Much less is known about possible long-term effects of prenatal smoking exposure [13,36]. Our results support the importance of familial factors for the association between prenatal smoking exposure and 14 offspring risk of suicidal acts.…”

Section: Discussionsupporting

confidence: 74%

“…For example, we had no information on alcohol use or infections. 13 We also investigated two possible biological pathways by which prenatal smoking exposure may influence offspring risk of suicidal acts. First, smoking is causally associated with reduced fetal growth [35], and low birth weight has previously been associated with suicidal acts [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Maternal smoking has been recognized as one of the most important risk factors for adverse pregnancy outcomes, including placental complications, fetal growth restriction, preterm birth and associated conditions [13]. Women with mental disorders are more often smokers than women without such disorders [14].…”

Section: Introductionmentioning

confidence: 99%

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Maternal smoking during pregnancy and risks of suicidal acts in young offspring

et al. 2011

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Word count (excluding title page, abstract, references and tables): 2,976. 2 AbstractObstetric and neonatal complications have been associated with completed and attempted suicide (suicidal acts) in young offspring. Maternal smoking is one of the most important risk factors for obstetric complications, but the association between prenatal smoking exposure and offspring risk of suicidal acts is unknown.We performed a population-based study of 1 449,333 single births born in Sweden between 1983 and 1996, derived from linked registry data. Maternal smoking and risks of suicidal acts in offspring were estimated using hazard ratios, derived from proportional-hazard models, controlling for potential confounding of parental socio-demographic factors and psychiatric care in first degree relatives. To control for unmeasured familial confounding, a matched case-control analysis of suicidal acts was performed within sibling pairs discordant for prenatal smoking exposure.In the cohort analysis, the adjusted hazard ratio for completed suicide among offspring to women smoking 1-9 cigarettes and at least 10 cigarettes per day were 1.67, 95% confidence interval (CI), 1.29-2.16, and 1.54, 95% CI, 1.12-2.10. For suicidal acts, corresponding hazard ratios were 1.28, 95% CI 1.21-1.35 and 1.48, 95% CI 1.39-1.57, respectively. However, in sibling pairs discordant for suicidal acts and prenatal smoking exposure, we found no evidence that prenatal smoking exposure increased the risk of suicidal acts. We conclude that the association between prenatal smoking exposure and offspring risk of suicidal acts is probably confounded by unmeasured familial factors.Word count: 230

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Maternal smoking during pregnancy and risks of suicidal acts in young offspring

et al. 2011

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“…Smoking also presents immediate risks for the mother, including placental abruption 7, as well as the long‐term risks reported for smokers in general. In high‐income countries, the prevalence of smoking during pregnancy is estimated to be between 10 and 26% 8, 9, 10, 11, 12, 13.…”

Section: Introductionmentioning

confidence: 99%

Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial

et al. 2016

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AimsTo examine the ability of different common measures of cigarette dependence to predict smoking cessation during pregnancy.DesignSecondary analysis of data from a parallel‐group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4 weeks post‐quit and end‐of‐pregnancy.SettingWomen identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial.ParticipantsOf 789 pregnant smokers recruited, 784 were included in the analysis.MeasurementsUsing random‐effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non‐Heaviness of Smoking Index (non‐HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio‐demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence.FindingsAll the dependence variables predicted abstinence at 4 weeks and end‐of‐pregnancy. At 4 weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47–0.74), expired CO = 0.54 (0.41–0.71), number of cigarettes smoked per day 0.65 (0.51–0.84) and frequency of urges to smoke 0.79 (0.63–0.98); at end‐of‐pregnancy they were: 0.60 (0.45–0.81), 0.55 (0.37–0.80), 0.70 (0.49–0.98) and 0.69 (0.51–0.94), respectively. HSI and non‐HSI exhibited similar results to the full FTCD.ConclusionsFour common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end‐of‐pregnancy with very similar predictive validity.

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“…Most studies have been unable to distinguish cohabiting mothers from married mothers, for instance, in a study of smoking during pregnancy in Sweden, 32 the authors grouped married and cohabiting mothers together. Other studies used indicators of female-headed households as a measure of maternal marital status.…”

Section: Introductionmentioning

confidence: 99%