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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Pregnancy planning, smoking behaviour during pregnancy, and neonatal outcome: UK millennium cohort study

Authors: Anika Flower, Jill Shawe, Judith Stephenson, Pat Doyle

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

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Abstract

Background

Pre-pregnancy health and care are important for the health of the future generations. Smoking during pregnancy has been well-researched and there is clear evidence of harm. But there has been little research on the health impact of planning for pregnancy. This study aims to investigate the independent effects of pregnancy planning and smoking during pregnancy on neonatal outcome.

Methods

This analysis made use of data from the UK Millennium Cohort Study. The study sample consisted of 18,178 singleton babies born in UK between 2000 and 2001. The neonatal outcomes of interest were low birthweight (<2.5 Kg) and pre-term birth (<37 completed weeks gestation). Logistic regression was used to estimate the association between pregnancy planning and/or smoking and neonatal outcome. Adjusted odds ratios were used to calculate population attributable risk fractions (PAFs).

Results

43% of mothers did not plan their pregnancy and 34% were smoking just before and/or during pregnancy. Planners were half as likely to be smokers just before pregnancy, and more likely to give up or reduce the amount smoked if smokers. Unplanned pregnancies had 24% increased odds of low birth weight and prematurity compared to planned pregnancies (AORLBW1.24, 95% CI 1.04-1.48; AORPREM1.24, 95% CI 1.05-1.45), independent of smoking status. The odds of low birth weight for babies of mothers who were smoking just before pregnancy was 91% higher than that of mothers who were not (AORLBW1.91, 95% CI 1.56-2.34). Women who quit or reduced the amount smoked during pregnancy lowered the risk of a low birth weight baby by one third (AORLBW0.66, 95% CI 0.51-0.85) compared with women whose smoking level did not change. Smaller effects were found for prematurity. If all women planned their pregnancy and did not smoke before or during pregnancy, 30% of low birthweight and 14% of prematurity could, in theory, be avoided.

Conclusions

Planning a pregnancy and avoiding smoking during pregnancy has clear, independent, health benefits for babies. Quitting or reducing the amount smoked during pregnancy can reduce the risk of low birthweight.
Appendix
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Literature
1.
Hanson M, Fall C, Robinson S, Baird J, BMA Board of Science: Early life nutrition and lifelong health. 2009, London: British Medical Association
2.
Gluckman P, Hanson M, Buklijas T, Low F, Beedle A: Epigenetic mechanisms that underpin metabolic and cardiovascular diseases. Nat Rev Endocrinol. 2009, 5 (7): 401-408. 10.1038/nrendo.2009.102.CrossRefPubMed
3.
Ben-Shlomo Y, Kuh D: A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002, 31 (2): 2-CrossRef
4.
5.
Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M, Baumann P: Smoking in pregnancy revisited: findings from a large population-based study. Am J Obstet Gynecol. 2005, 192: 1856-1863. 10.1016/j.ajog.2004.12.057.CrossRefPubMed
6.
Salihu HM, Wilson RE: Epidemiology of prenatal smoking and perinatal outcomes. Early Hum Dev. 2007, 83 (11): 713-720. 10.1016/j.earlhumdev.2007.08.002.CrossRefPubMed
7.
U.S. Department of Health and Human Services: The health consequences of smoking. 2004 Surgeon General’s Report. 2004, U.S: Department of Health and Human Services
8.
Inequalities Unit Department of Health: Review of the health inequalities infant mortality PSA target. 2007, London: Department of Health
9.
NICE Public Health guidance 26: Quitting smoking in pregnancy and following childbirth. 2010, Manchester: National Institute for health and Clinical Excellence
10.
11.
Bruzzi P, Green SB, Byar DP, Brinton LA, Schairer C: Estimating the population attributable risk for multiple risk factors using case–control data. Am J Epidemiol. 1985, 122 (5): 904-914.PubMed
12.
Lindqvist R, Lendahls L, Tollbom Ö, ÅBerg H, Håkansson A: Smoking during pregnancy: comparison of self-reports and cotinine levels in 496 women. Acta Obstet Gynecol Scand. 2002, 81: 240-244. 10.1034/j.1600-0412.2002.810309.x.CrossRefPubMed
13.
Hamlyn B, Brooker S, Oleinikova K, Wands S: Infant feeding 2000: A survey conducted on behalf of the Department of Health, the Scottish Executive, the National Assembly for Wales and the Department of Health Social Services and Public Safety in Northern Ireland. 2002, London: The Stationery Office
14.
15.
Carson C, Kelly Y, Kurinczuk JJ, Sacker A, Redshaw M, Quigley MA: Effect of pregnancy planning and fertility treatment on cognitive outcomes in children at ages 3 and 5: longitudinal cohort study. BMJ. 2011, 243: d4473-CrossRef
16.
Graham H, Sherburne Hawkins S, Law C: Lifecourse influences on women’s smoking before, during and after pregnancy. Soc Sci Med. 2010, 70 (4): 582-587. 10.1016/j.socscimed.2009.10.041.CrossRefPubMed
17.
Arslan OI, Mete S: Pregnancy planning and antenatal health behaviour: findings from one maternity unit in Turkey. Midwifery. 2010, 26 (3): 338-347. 10.1016/j.midw.2008.07.005.CrossRef
18.
Type’n T, Stern J, Nydahl M, Berglund A, Larsson M, Rosenblad A: Pregnancy planning in Sweden-a pilot study among 270 women attending antenatal clinics. Acta Obstet Gynecol Scand. 2011, 90 (4): 408-412. 10.1111/j.1600-0412.2010.01055.x.CrossRef
19.
Morin P, De Wals P, Noiseux M, Niyonsenga T, St-Cyr-Tribble D, Tremblay C: Pregnancy planning and folic acid. Prev Med. 2002, 35: 143-149. 10.1006/pmed.2002.1041.CrossRefPubMed
20.
Green-Raleigh K, Carter H, Mulinare J, Prue C, Petrini J: Trends in folic Acid awareness and behavior in the United States: the Gallup Organization for the March of Dimes Foundation surveys, 1995–2005. Matern Child Health J. 2006, 10 (5): S177-S182.CrossRefPubMed
21.
Sheeder J, Tocce K, Stevens-Simon C: Reasons for ineffective contraceptive use antedating adolescent pregnancies: part 2: a proxy for childbearing intentions. Matern Child Health J. 2009, 13 (3): 306-317. 10.1007/s10995-008-0368-7.CrossRefPubMed
22.
Chou FH, Avant KC, Kuo SH, Fetzer SJ: Relationships between nausea and vomiting, perceived stress, social support, pregnancy planning, and psychosocial adaptation in a sample of mothers: a questionnaire survey. Int J Nurs Stud. 2008, 45 (8): 1185-1191. 10.1016/j.ijnurstu.2007.08.004.CrossRefPubMed
23.
Yanikkerem E, Ay S, Piro N: Planned and unplanned pregnancy: effects on health practice and depression during pregnancy. J Obstet Gynaecol Res. 2013, 39 (1): 180-187. 10.1111/j.1447-0756.2012.01958.x.CrossRefPubMed
24.
Fergusson DM, Horwood LJ, Shannon FT: Smoking during pregnancy. N Z Med J. 1979, 89 (628): 41-43.PubMed
25.
Watanabe H, Inoue K, Doi M, Matsumoto M, Ogasawara K, Fukuoka H, et al: Risk factors for term small for gestational age infants in women with low prepregnancy body mass index. J Obstet Gynaecol Res. 2010, 36 (3): 506-512. 10.1111/j.1447-0756.2010.01170.x.CrossRefPubMed
26.
Vedmedovska N, Rezeberga D, Teibe U, Zodzika J, Donders GG: Preventable maternal risk factors and association of genital infection with fetal growth restriction. Gynecol Obstet Invest. 2010, 70 (4): 291-298. 10.1159/000314020.CrossRefPubMed
27.
St-Laurent J, De Wals P, Moutquin JM, Niyonsenga T, Noiseux M, Czernis L: Biopsychosocial determinants of pregnancy length and fetal growth. Paediatr Perinat Epidemiol. 2008, 22 (3): 240-248. 10.1111/j.1365-3016.2008.00926.x.CrossRefPubMed
28.
Pringle PJ, Geary MP, Rodeck CH, Kingdom JC, Kayamba-Kay’s S, Hindmarsh PC: The influence of cigarette smoking on antenatal growth, birth size, and the insulin-like growth factor axis. J Clin Endocrinol Metabol. 2005, 90 (5): 2556-2562. 10.1210/jc.2004-1674.CrossRef
29.
Lumley J, Oliver SS, Chamberlain C, Oakley L: Interventions for promoting smoking cessation during pregnancy. Cochrane Database Syst Rev. 2004, 4: CD001055
Metadata
Title
Pregnancy planning, smoking behaviour during pregnancy, and neonatal outcome: UK millennium cohort study
Authors
Anika Flower
Jill Shawe
Judith Stephenson
Pat Doyle
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-238

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