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Clustering of Socioeconomic, Behavioural, and Neonatal Risk Factors for Infant Health in Pregnant Smokers

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  • Caren I Lanting
  • Simone E Buitendijk
  • Matty R Crone
  • Dewi Segaar
  • Jack Bennebroek Gravenhorst
  • Jacobus P van Wouwe

Abstract

Background: Tobacco smoking is a major cause of morbidity and mortality, including during pregnancy. Although effective ways of promoting smoking cessation during pregnancy exist, the impact of these interventions has not been studied at a national level. We estimated the prevalence of smoking throughout pregnancy in the Netherlands and quantified associations of maternal smoking throughout pregnancy with socioeconomic, behavioural, and neonatal risk factors for infant health and development. Methodology/Principal Findings: Data of five national surveys, containing records of 14,553 Dutch mothers and their offspring were analyzed. From 2001 to 2007, the overall rate of smoking throughout pregnancy fell by 42% (from 13.2% to 7.6%) mainly as a result of a decrease among highly educated women. In the lowest-educated group, the overall rate of smoking throughout pregnancy was six times as high as in the highest-educated group (18.7% versus 3.2%). Prenatal tobacco smoke exposure was associated with increased risk of extremely preterm (≤28 completed weeks) (OR 7.25; 95% CI 3.40 to 15.38) and small-for-gestational age (SGA) infants (OR 3.08; 95% CI 2.66 to 3.57). Smoking-attributable risk percents in the population (based on adjusted risk ratios) were estimated at 29% for extremely preterm births and at 17% for SGA outcomes. Infants of smokers were more likely to experience significant alcohol exposure in utero (OR 2.08; 95%CI 1.25 to 3.45) and formula feeding in early life (OR 1.91; 95% CI 1.69 to 2.16). Conclusions: The rates of maternal smoking throughout pregnancy decreased significantly in the Netherlands from 2001 to 2007. If pregnant women were to cease tobacco use completely, an estimated 29% of extremely preterm births and 17% of SGA infants may be avoided annually.

Suggested Citation

  • Caren I Lanting & Simone E Buitendijk & Matty R Crone & Dewi Segaar & Jack Bennebroek Gravenhorst & Jacobus P van Wouwe, 2009. "Clustering of Socioeconomic, Behavioural, and Neonatal Risk Factors for Infant Health in Pregnant Smokers," PLOS ONE, Public Library of Science, vol. 4(12), pages 1-6, December.
    • Handle: RePEc:plo:pone00:0008363
    DOI: 10.1371/journal.pone.0008363
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    1. Northridge, M.E., 1995. "Public health methods--attributable risk as a link between causality and public health action," American Journal of Public Health, American Public Health Association, vol. 85(9), pages 1202-1204.
    2. Horta, B.L. & Kramer, M.S. & Platt, R.W., 2001. "Maternal smoking and the risk of early weaning: A meta-analysis," American Journal of Public Health, American Public Health Association, vol. 91(2), pages 304-307.
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    1. Gerrit van den Berg & Manon van Eijsden & Tanja G M Vrijkotte & Reinoud J B J Gemke, 2012. "Educational Inequalities in Perinatal Outcomes: The Mediating Effect of Smoking and Environmental Tobacco Exposure," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-6, May.
    2. Anh Ngo & Geoffrey T. Fong & Lorraine V. Craig & Ce Shang, 2019. "Analysis of Gender Differences in the Impact of Taxation and Taxation Structure on Cigarette Consumption in 17 ITC Countries," IJERPH, MDPI, vol. 16(7), pages 1-11, April.
    3. George L. Wehby & Kaitlin Prater & Ann Marie McCarthy & Eduardo E. Castilla & Jeffrey C. Murray, 2011. "The Impact of Maternal Smoking during Pregnancy on Early Child Neurodevelopment," Journal of Human Capital, University of Chicago Press, vol. 5(2), pages 207-254.

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