In addition to public health services, private health insurance and services are also available in Botucatu. Systematic sampling was used in this study: all pregnant women admitted to give birth at either of the two maternity hospitals during the study period from January 1 to June 30, , were considered eligible for the study.
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Only women pregnant with a single fetus were included in the study. All subjects gave informed written consent prior to their participation in the study, in accordance with established principles of research ethics. The variable under investigation was smoking during pregnancy classified as: no; yes, from 1 to 5 cigarettes per day; yes, from 6 to 10 cigarettes per day and yes, from 11 to 40 cigarettes per day.
With this option, the study aimed to analyze the effect of different intensities of smoking on birth weight of the newborn compared to the birth weight of newborns from nonsmoker pregnant women. Smoking during pregnancy data were obtained from medical records Women classified as smokers during gestation were those who reported having maintained this habit throughout pregnancy.
Data were also collected on potentially confounding sociodemographic, medical and behavioral variables. Infant data were also collected to evaluate effects. The outcome variable was birth weight g.
Given the close relationship between birth weight and gestational age, the effects of smoking on term and premature newborns were studied separately [ 15 , 16 ]; therefore, data were also collected on the birth condition preterm, full-term for stratification. Just as for the data on smoking, all these other data were obtained from maternal or infant medical records including prenatal care cards and records from the delivery room or the nursery during hospital admission for delivery.
All data were collected by authorized health service professionals, under the supervision of a doctoral student in public health who was responsible for quality control. The data were input to a database and checked for consistency before statistical analysis. The data analyses were performed in two phases. In the second phase, the smoking effect, corrected for the effect of the identified confounders, was estimated using a gamma response regression model adjusted analysis.
This model was selected for its ability to simultaneously estimate the main effect and correct for the effect of potential confounders following the asymmetric probability distribution of the outcome.
Considering premature and term newborns, most mothers lived with a partner respectively , employed The prevalence of smoking was The preterm birth rate was Sociodemographic, medical and prenatal characteristics, and smoking status of pregnant women in Botucatu, Brazil. Again, no significant difference in birth weight was found in relation to smoking. Newborn weight decreased as the category of number of cigarettes per day increased, with a significant reduction at the 6 to 10 cigarettes: when mothers smoked 6 to 10 cigarettes per day, infant weight was This study evaluated the prevalence of smoking and the relationship between birth weight and smoking intensity in a population of women who gave birth in a medium-sized city in southeastern Brazil.
The impact of tabagism was evaluated using a cathegorized pattern instead of a continuous variable, because of the irregular distribution of the variable and high proportion of zeros nonsmoker mothers. That procedure was performed so that a dilution of the smoking effect could be avoided mean effect , and the impact of different loads of maternal smoking could be detected: 1 to 5 cigarretes per day or light smokers, 6 to 10 or medium smokers and 11 to 40 or heavier smokers.
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Analysis of the premature infant data showed no statistically significant differences between the birth weight of infants born to smoking and nonsmoking pregnant women. In contrast, the analysis of full-term infants revealed a negative, dose—response effect of smoking on newborn weight. This effect was observed even after correction for identified potential confounders, such as maternal age, presence of a partner, parity, interval between deliveries, number of prenatal medical visits, emotional problems in pregnancy, illegal drug use, anemia, high blood pressure, hyperemesis, gestational age and infection during pregnancy.
Interestingly, no statistically significant differences were found in mean birth weight when mothers smoked 1—5 cigarettes per day. An important consideration is that the accuracy of the data on smoking and the number of cigarettes smoked per day during pregnancy may limit the validity of the study findings. It is known that the number of cigarettes smoked per day can vary throughout pregnancy [ 17 ], and this was not addressed in the cross-sectional design of the present study, which relied on self-reporting at the time of delivery or medical records.
Besides, women who reported having quit the habit just at the beginning of gestation were considered as nonsmokers, and the passive exposure to tobacco smoke non investigated was not considered, which could result in some underestimation of the smoking effect on birth weight. Nevertheless, an important negative effect was observed. The data are representative of a single place in the southeastern region of Brazil. The prevalence of smoking in the pregnant women that was found in our study overall prevalence of Furthermore, smoking effects are mainly a result of biological processes, and that fact also may support the generalization of our findings.
Nevertheless, it is likely that in similar contexts and populations middle-income countries with good availability of prenatal care , tobacco use during pregnancy will negatively affect term newborn weight to a similar extension as it did in the present study. Others may be encouraged to quit smoking, through concerted counseling about the risks of smoking to fetus and mother that begins at the initiation of prenatal care [ 18 ]. On the whole, pregnant women are receptive to educational measures and health promotion [ 17 ] and are more likely to consider smoking cessation in the context of the frequent contact with health professionals during prenatal care [ 9 ].
Accordingly, the prenatal protocol of the Brazilian Health Ministry [ 16 ] instructs that smoking pregnant women be identified in prenatal medical visits, advised to quit and offered support to achieve this goal.
Study: Smoking while pregnant doubles risk of sudden infant death | American Academy of Pediatrics
As such, the findings of the study population are worrying. It is likely that not all pregnant women were appropriately counseled during their medical visits. The high prevalence of smoking in the study population shows that actions to address prevention of tobacco use in general and, particularly, during prenatal care, have been inadequate in the study region.
Despite the need for smoking cessation, it may be more challenging to achieve it during pregnancy, especially considering that a powerful psychoactive drug, nicotine, causes chemical addiction to smoking [ 19 ]. Nicotine replacement therapy has been effective in helping the addicted population to quit smoking [ 20 ] and thus, reduces harm from smoking; however, its use during pregnancy is controversial [ 21 ]. Questions remain about long-term effects and the safety of nicotine replacement therapy during pregnancy and the postpartum period [ 13 , 21 , 22 ].
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From the perspective of practical advice for pregnant women unable to quit smoking, the study findings support the recommendation of less than six cigarettes a day to minimize the negative effects of smoking on newborn weight; however, this must be validated with further studies evaluating the effects of reduced tobacco use on birth weight and on other outcomes, such as prematurity, stillbirth and sudden infant death syndrome. The study showed that smoking during pregnancy is associated with lower birth weight in full-term infants. E-mail to a friend Please fill in all fields.
Please enter a valid e-mail address. Thank you! Your e-mail was sent. Save to my dashboard Sign in or Sign up to save this page. Saving Just a moment, please. You've saved this page It's been added to your dashboard. In This Topic View More. How is smoking harmful to your body? Smoking harms nearly every organ in the body. It can cause serious health conditions, including: Addiction Cancer of the lung, mouth, throat, kidneys and other organs.
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It also causes cancer of the blood also called leukemia. Heart disease and lung disease Diabetes Stroke. This is when a blood clot blocks a blood vessel that brings blood to the brain, or when a blood vessel in the brain bursts open. Gum disease Eye problems that can lead to blindness How can smoking harm your pregnancy?
This is labor than starts too early, before 37 weeks of pregnancy. Preterm labor can lead to premature birth. Babies born prematurely are more likely to have health problems at birth and later in life than babies born on time. Ectopic pregnancy.
The Influence of Maternal Smoking During Pregnancy on the Toddler's Negativity
This is when a fertilized egg implants itself outside of the uterus womb and begins to grow. An ectopic pregnancy always ends in pregnancy loss. It can cause serious, dangerous problems for a pregnant woman. Most of the time, ectopic pregnancies are removed by surgery. Bleeding from the vagina Problems with the placenta, like placental abruption and placenta previa. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord. Placental abruption is a serious condition in which the placenta separates from the wall of the uterus before birth.
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina.
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