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Open Access 22-09-2023

Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) Analysis

Authors: Rauta Aver Yakubu, Kobi V. Ajayi, Shubhecchha Dhaurali, Keri Carvalho, Anna Kheyfets, Blessing Chidiuto Lawrence, Ndidiamaka Amutah-Onukagha

Published in: Maternal and Child Health Journal | Special Issue 1/2023

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Abstract

Objective

To examine the smoking patterns of women who experienced stressful life events and the impact of racial disparities on the relationship between stressful life events, and prenatal/ postpartum smoking.

Methods

The study analyzed data from the Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) survey across five states (CT, LA, MA, MO, WI). Four stressful life event categories were created using thirteen affiliated questions: financial, trauma, partner, and emotional. We assessed: 1) the association between smoking and stressful life events, 2) the impact of race on the relation between smoking and stressful life events, and 3) the long-term effects of smoking on health by assessing the association between smoking and maternal morbidity. Bivariate statistics and multivariate Poisson regression models were conducted.

Results

A total of 24,209 women from five states were included. 8.9% of respondents reported smoking during pregnancy, and 12.7% reported smoking postpartum. There was a significant association between all stressful life events and smoking. Trauma stressful life event had the strongest association with smoking during pregnancy (adjusted PR=2.01; CI: 1.79-2.27) and postpartum (adjusted PR= 1.80; CI: 1.64-1.98). Race and stressful life event interaction effects on smoking had varied significant findings, but at least one racial/ ethnic minority group (Black, Hispanic, Asian) had a higher smoking prevalence than non-Hispanic White per stressful life event category. Lastly, the prevalence of maternal morbidity was higher for smoking during pregnancy (adjusted PR= 1.28; CI: 1.19-1.38) and postpartum (adjusted PR= 1.30; CI: 1.22-1.38) compared to no smoking.

Conclusions for Practice

Culturally congruent, multi-disciplinary care teams are needed to address both clinical and social needs to reduce stressful life events and smoking. Screenings for stress should be standardized with a referral system in place to provide ongoing support.
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Metadata
Title
Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) Analysis
Authors
Rauta Aver Yakubu
Kobi V. Ajayi
Shubhecchha Dhaurali
Keri Carvalho
Anna Kheyfets
Blessing Chidiuto Lawrence
Ndidiamaka Amutah-Onukagha
Publication date
22-09-2023
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue Special Issue 1/2023
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-023-03773-7

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