The Effects of Different Smoking Patterns in Pregnancy on Perinatal Outcomes in the Southampton Women’s Survey

Martin M. O’Donnell, Janis Baird, Cyrus Cooper, Sarah R. Crozier, Keith M. Godfrey, Michael Geary, Hazel M. Inskip and Catherine B. Hayes
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Martin M. O’Donnell: Mater Misericordiae University Hospital, Eccles Street, D07 R2WY Dublin, Ireland
Janis Baird: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
Cyrus Cooper: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
Sarah R. Crozier: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
Keith M. Godfrey: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
Michael Geary: Department of Obstetrics and Gynaecology, The Rotunda Hospital, D01 P5W9 Dublin, Ireland
Hazel M. Inskip: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK
Catherine B. Hayes: Discipline of Public Health and Primary Care, Trinity College Dublin, D24 DH74 Dublin, Ireland

IJERPH, 2020, vol. 17, issue 21, 1-13

Abstract: Maternal smoking during pregnancy has established associations with poor perinatal outcomes. Among continuing pregnant smokers, harm-reduction strategies have been suggested, including temporary cessation of smoking during pregnancy, also known as partial quitting. Support for this strategy, however, remains limited. Six hundred and ninety-seven women in the Southampton Women’s Survey who smoked at their last menstrual period were categorised into sustained quitters, partial quitters (quit in either the first or third trimester but not both) or sustained smokers (continued to smoke throughout pregnancy). In regression models, compared with infants born to sustained smokers, infants born to sustained quitters and partial quitters were heavier at birth by β = 0.64 standard deviations (SD) (WHO z-score) (95% CI: 0.47–0.80) and 0.48 SD (WHO z-score) (95% CI: 0.24–0.72) respectively, adjusted for confounders, with similar patterns seen for other anthropometric measures (head circumference and crown–heel length). Sustained quitters had longer gestations by β = 3.5 days (95% CI: 1.8–5.2) compared with sustained smokers, but no difference was seen for partial quitters. While sustained quitting remains the most desired outcome for pregnant smokers, partial quitting should be explored as a strategy to reduce some of the harmful effects of smoking on offspring in those who cannot achieve sustained quitting.

Keywords: smoking; pregnancy; partial quitting; perinatal outcomes; birthweight; gestation; head circumference; crown–heel length; anthropometry (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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