Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 6/2010

01-11-2010

Smoking Among Pregnant Women with Medicaid Insurance: Are Mental Health Factors Related?

Authors: Jodi Summers Holtrop, Cristian Meghea, Jennifer E. Raffo, Lynette Biery, Shelby Berkowitz Chartkoff, LeeAnne Roman

Published in: Maternal and Child Health Journal | Issue 6/2010

Login to get access

Abstract

Smoking during pregnancy is the single most modifiable risk factor for poor birth outcomes, yet it remains prevalent among low-income women. This study examined factors associated with continued smoking and quitting among pregnant women. A total of 2,203 Medicaid-eligible pregnant women were screened at their first enhanced prenatal services visit for risk factors including demographics, health behaviors (smoking, alcohol and drug use), mental health (history of mental health disorders, current depressive symptoms), and stress. Smoking status was divided into non-smokers, quitters (quit smoking since learning of pregnancy), and continuing smokers. Descriptive statistics and logistic regression models were used to describe the sample and analyze relationships between smoking status and other characteristics. Overall, 57% were non-smokers, 17% quitters, and 26% continuing smokers. Approximately 18% had severe depressive symptoms, 53% had a high stress score, and 33% had a history of mental health problems. Younger women had lower odds of continued smoking as compared to both non-smokers (OR = 0.48, p < 0.01) and quitters (OR = 0.56, p < 0.05). Older women with less than a 12th grade education had higher odds of continued smoking (OR = 2.17, p < 0.01) and quitting (OR = 1.62, p < 0.05) as compared to non-smokers. Alcohol use (OR = 2.81, p < 0.05) and drug use before pregnancy (OR = 5.32, p < 0.01) predicted continued smoking compared to non-smoking. Women with a mental health history (OR = 1.81, p < 0.01) and high stress scores (OR = 1.39, p < 0.05) had higher odds of continued smoking compared to non-smokers. Mental health history, stress, demographics, current alcohol and past drug use are strongly related to continued smoking in this population.
Literature
1.
Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States 2000. JAMA, 291(10), 1238–1245.CrossRefPubMed
2.
US Department of Health and Human Services. (2001). Women and smoking: A report of the surgeon general. Report summary. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
3.
Lannero, E., Wickman, M., Pershagen, G., & Nordvall, L. (2006). Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE). Respiratory Research, 7, 3.CrossRefPubMed
4.
US Department of Health and Human Services. (2004). The health consequences of smoking: A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
5.
Malik, S., Cleves, M. A., Honein, M. A., Romitti, P. A., Botto, L. D., Yang, S., et al. (2008). Maternal smoking and congenital heart defects. Pediatrics, 121(4), e810–e816.CrossRefPubMed
6.
Colman, G. J., & Joyce, T. (2003). Trends in smoking before, during, and after pregnancy in ten states. American Journal of Preventive Medicine, 24(1), 29–35.CrossRefPubMed
7.
Tong, V. T., Jones, J. R., Dietz, P. M., D’Angelo, D., & Bombard, J. M. (2009). Trends in smoking before, during, and after pregnancy—pregnancy risk assessment monitoring system (PRAMS), United States, 31 sites, 2000–2005. MMWR Surveillance Summaries, 58(4), 1–29.
8.
Kahn, R. S., Certain, L., & Whitaker, R. C. (2002). A reexamination of smoking before, during, and after pregnancy. American Journal of Public Health, 92(11), 1801–1808.CrossRefPubMed
9.
Orr, S. T., Blazer, D. G., James, S. A., & Reiter, J. P. (2007). Depressive symptoms and indicators of maternal health status during pregnancy. Journal of Womens Health (Larchmt), 16(4), 535–542.CrossRef
10.
Blalock, J. A., Robinson, J. D., Wetter, D. W., & Cinciripini, P. M. (2006). Relationship of DSM-IV-based depressive disorders to smoking cessation and smoking reduction in pregnant smokers. The American Journal on Addictions, 15(4), 268–277.CrossRefPubMed
11.
Orr, S. T., Newton, E., Tarwater, P. M., & Weismiller, D. (2005). Factors associated with prenatal smoking among black women in eastern North Carolina. Maternal and Child Health Journal, 9(3), 245–252.CrossRefPubMed
12.
Blalock, J. A., Fouladi, R. T., Wetter, D. W., & Cinciripini, P. M. (2005). Depression in pregnant women seeking smoking cessation treatment. Addictive Behaviors, 30(6), 1195–1208.CrossRefPubMed
13.
Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Womens Health (Larchmt), 12(4), 373–380.CrossRef
14.
Zhu, S. H., & Valbo, A. (2002). Depression and smoking during pregnancy. Addictive Behaviors, 27(4), 649–658.CrossRefPubMed
15.
Ludman, E. J., McBride, C. M., Nelson, J. C., Curry, S. J., Grothaus, L. C., Lando, H. A., et al. (2000). Stress, depressive symptoms, and smoking cessation among pregnant women. Health Psychology, 19(1), 21–27.CrossRefPubMed
16.
Goodwin, R. D., Keyes, K., & Simuro, N. (2007). Mental disorders and nicotine dependence among pregnant women in the United States. Obstetrics and Gynecology, 109(4), 875–883.PubMed
17.
Flick, L. H., Cook, C. A., Homan, S. M., McSweeney, M., Campbell, C., & Parnell, L. (2006). Persistent tobacco use during pregnancy and the likelihood of psychiatric disorders. American Journal of Public Health, 96(10), 1799–1807.CrossRefPubMed
18.
Kavanaugh, M., McMillen, R. C., Pascoe, J. M., Hill Southward, L., Winickoff, J. P., & Weitzman, M. (2005). The co-occurrence of maternal depressive symptoms and smoking in a national survey of mothers. Ambulatory Pediatrics, 5(6), 341–348.CrossRefPubMed
19.
Roman, L. A., Meghea, C. I., Raffo, J. E., Biery, H. L., Chartkoff, S. B., & Zhu, Q., et al. (2008). Who participates in state sponsored medicaid enhanced prenatal services? Maternal and Child Health Journal.
20.
Mullen, P. D., Carbonari, J. P., Tabak, E. R., & Glenday, M. C. (1991). Improving disclosure of smoking by pregnant women. American Journal of Obstetrics and Gynecology, 165(2), 409–413.PubMed
21.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The fagerstrom test for nicotine dependence: A revision of the fagerstrom tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127.CrossRefPubMed
22.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. Applications to addictive behaviors. The American Psychologist, 47(9), 1102–1114.CrossRefPubMed
23.
DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59(2), 295–304.CrossRefPubMed
24.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRefPubMed
25.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292.CrossRefPubMed
26.
Murray, D. C. J. (1990). Screening for depression during pregnancy with the edinburgh postnatal depression scale (EPDS). Journal of Reproductive and Infant Psychology, 8, 63–65.CrossRef
27.
Harrison, P. A., & Sidebottom, A. C. (2008). Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Maternal and Child Health Journal.
28.
Burns, L., Mattick, R. P., & Wallace, C. (2008). Smoking patterns and outcomes in a population of pregnant women with other substance use disorders. Nicotine and Tobacco Research, 10(6), 969–974.CrossRefPubMed
29.
Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychology Measurement, (1), 385–401.
30.
McCormick, M. C., Brooks-Gunn, J., Shorter, T., Holmes, J. H., Wallace, C. Y., & Heagarty, M. C. (1990). Factors associated with smoking in low-income pregnant women: Relationship to birth weight, stressful life events, social support, health behaviors and mental distress. Journal of Clinical Epidemiology, 43(5), 441–448.CrossRefPubMed
31.
Higgins, S. T., Heil, S. H., Badger, G. J., Mongeon, J. A., Solomon, L. J., McHale, L., et al. (2007). Biochemical verification of smoking status in pregnant and recently postpartum women. Experimental and Clinical Psychopharmacology, 15(1), 58–66.CrossRefPubMed
32.
Klebanoff, M. A., Levine, R. J., Morris, C. D., Hauth, J. C., Sibai, B. M., Ben Curet, L., et al. (2001). Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatric and Perinatal Epidemiology, 15(2), 140–143.CrossRefPubMed
33.
Clinical Practice Guideline Treating Tobacco Use and Dependence. (2008). Update panel. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A US Public Health Service report. American Journal of Preventive Medicine, 35(2), 158–76.
Metadata
Title
Smoking Among Pregnant Women with Medicaid Insurance: Are Mental Health Factors Related?
Authors
Jodi Summers Holtrop
Cristian Meghea
Jennifer E. Raffo
Lynette Biery
Shelby Berkowitz Chartkoff
LeeAnne Roman
Publication date
01-11-2010
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 6/2010
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-009-0530-x

Other articles of this Issue 6/2010

Maternal and Child Health Journal 6/2010 Go to the issue

OriginalPaper

Conceptual and Measurement Issues in Early Parenting Practices Research: An Epidemiologic Perspective

OriginalPaper

Racial/Ethnic Disparities in the Receipt of Smoking Cessation Interventions During Prenatal Care

OriginalPaper

Insurance-Based Discrimination During Prenatal Care, Labor, and Delivery: Perceptions of Oregon Mothers

OriginalPaper

Prevalence and Risk Factors for Adult Paternity Among Adolescent Females Ages 14 through 16 Years

Notes from the Field

Recognizing Excellence in Maternal and Child Health (MCH): 2009 National MCH Epidemiology Awards

OriginalPaper

Comparison of Olive Oil and Dry-Clean Keeping Methods in Umbilical Cord Care as Microbiological