Abstract
Cigarette smoking during pregnancy is one of the most preventable causes of infant morbidity and mortality, yet 80 % of women who smoked prior to pregnancy continue to smoke during pregnancy. Past studies have found that lower maternal–fetal attachment predicts smoking status in pregnancy, yet past research has not examined whether maternal–fetal attachment predicts patterns or quantity of smoking among pregnant smokers. The aim of this study was to examine the relationship between maternal–fetal attachment and patterns of maternal smoking among pregnant smokers. We used self-reported and biochemical markers of cigarette smoking in order to better understand how maternal–fetal attachment relates to the degree of fetal exposure to nicotine. Fifty-eight pregnant smokers participated in the current study. Women completed the Maternal–Fetal Attachment Scale, reported weekly smoking behaviors throughout pregnancy using the Timeline Follow Back interview, and provided a saliva sample at 30 and 35 weeks gestation and 1 day postpartum to measure salivary cotinine concentrations. Lower maternal–fetal attachment scores were associated with higher salivary cotinine at 30 weeks gestation and 1 day postpartum. As well, women who reported lower fetal attachment reported smoking a greater maximum number of cigarettes per day, on average, over pregnancy. Lower maternal–fetal attachment is associated with greater smoking in pregnancy. Future research might explore whether successful smoking cessation programs improve maternal assessments of attachment to their infants.
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References
Andres, R. L., & Day, M. C. (2000). Perinatal complications associated with maternal tobacco use. Seminars in Neonatology, 5, 231–341.
Services, U. S. D. o. H. a. H. (2006). The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general (O. o. S. a. Health, Trans.). Rockville: Centers for Disease Control and Prevention.
Hannover, W., Thyrian, J. R., Roske, K., et al. (2008). Smoking cessation and relapse prevention for postpartum women: Results from a randomized controlled trial at 6, 12, 18, and 24 months. Addictive Behaviors, 34(1), 1–8.
Newport, D. J., Brennan, P. A., Green, P., et al. (2008). Maternal depression and medication exposure during pregnancy: Comparison of maternal retrospective recall to prospective documentation. BJOG: An International Journal of Obstetrics & Gynecology, 115, 681–688.
Gaffney, K. F., Beckwitt, M. A., & Friesen, M. A. (2008). Mothers’ reflections about infant irritability and postpartum tobacco use. Birth, 35(1), 66–72.
Quesada, O., Gotman, N., Howell, H. B., et al. (2012). Prenatal hazardous substance use and adverse birth outcomes. Journal of Maternal-Fetal and Neonatal Medicine, 25(8), 1222–1227.
Crawford, J. T., Tolosa, J. E., & Goldenberg, R. L. (2008). Smoking cessation in pregnancy: Why, how, and what’s next. Clinical Obstetrics and Gynecology, 51(2), 419–435.
DiSantis, K. I., Collins, B. N., & McCoy, A. C. (2010). Associations among breastfeeding, smoking relapse, and prenatal factors in a brief postpartum smoking intervention. Acta Obstetricia et Gynecologica Scandinavica, 89(4), 582–586.
Lauria, L., Lamberti, A., & Grandolfo, M. (2012). Smoking behaviour before, during, and after pregnancy: The effect of breastfeeding. Scientific World Journal. doi:10.1100/2012/154910.
Studies, O. o. A. (2005). Results from the 2002 National Survey on Drug Use and Health: National Findings. Washington DC: US Department of Health and Human Services; Substance Abuse and Mental Health Services Administration.
Alhusen, J. L., Gross, D., Hayat, M. J., et al. (2012). The influence of maternal–fetal attachment and health practices on neonatal outcomes in low-income urban women. Research in Nursing & Health, 35, 112–120.
Lindgren, K. (2001). Relationships among maternal–fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24, 203–217.
Cranley, M. S. (1981). Development of a tool for the measurement of maternal attachment during pregnancy. Nursing Research, 30(5), 281–284.
Walsh, R. A. (1994). Effects of maternal smoking on adverse pregnancy outcomes: Examination of the criteria of causation. Human Biology, 66(6), 1059–1092.
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., et al. (1991). The Fagerstrom test for nicotine dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127.
Fenton, T. R., & Sauve, R. S. (2007). Using the LMS method to calculate z-scores for the Fenton preterm infant growth chart. European Journal of Clinical Nutrition, 61(12), 1380–1385.
Benowitz, N. L. (1996). Cotinine as a biomarker of environmental tobacco smoke exposure. Epidemiologic Reviews, 18(2), 188–204.
Sobell, I. C., Brown, J., Leo, G. I., et al. (1996). The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug and Alcohol Dependence, 42, 49–54.
Salimetrics. (2006). High sensitivity salivary cotinine quantitative enzyme immunoassay kit (p. 3). State College, PA: Salimetrics LLC.
Savage, C., Wray, J., Ritchey, P. N., et al. (2003). Current screening instruments related to alcohol consumption in pregnancy and a proposed alternative method. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 32(4), 437–446.
Dum, M., Sobell, L. C., Sobell, M. B., et al. (2009). A quick drinking screen for identifying women at risk for an alcohol-exposed pregnancy. Addictive Behaviors, 34(9), 714–716.
Slade, P., Laxton-Kane, M., & Spiby, H. (2006). Smoking in pregnancy: The role of the transtheoretical model and the mother’s attachment to the fetus. Addictive Behaviors, 31(5), 743–757.
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This work was supported by a grant from the National Institutes of Health (R01 DA019558) to L.R.S. and a Flight Attendant Medical Research Institute Clinical Innovator Award to L.R.S.
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Magee, S.R., Bublitz, M.H., Orazine, C. et al. The Relationship Between Maternal–Fetal Attachment and Cigarette Smoking Over Pregnancy. Matern Child Health J 18, 1017–1022 (2014). https://doi.org/10.1007/s10995-013-1330-x
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DOI: https://doi.org/10.1007/s10995-013-1330-x