Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Maternal pregnancy smoking in three Brazilian cities: trends and differences according to education, income, and age

Abstract

Objectives

To estimate and assess pregnancy smoking trends since 1978, according to sociodemographic characteristics, in three Brazilian sites.

Methods

We used cross-sectional data from the perinatal studies of nine birth cohorts, located in the southeast (Ribeirão Preto—1978/1979, 1994, and 2010), south (Pelotas—1982, 1993, 2004, and 2015), and northeast (São Luís—1997/1998 and 2010) regions of Brazil. We estimated the prevalence of pregnancy smoking at each time point according to age, education, and family income, in each cohort, and evaluated smoking trends.

Results

We analyzed data of 17,275 women in Ribeirão Preto, 19,819 in Pelotas, and 7753 in São Luís. Smoking decreased by 59% in Ribeirão Preto (p < 0.001), 54% in Pelotas (p < 0.001), and 32% in São Luís (p < 0.001). However, among those with 0–4 years of education, smoking did not change in Ribeirão Preto (p-trend = 0.501) nor São Luís (p = 0.556) and increased in Pelotas (p-trend = 0.003).

Conclusions

Pregnancy smoking has been declining during the last decades. However, among less-educated women, pregnancy smoking did not change in two sites and increased in one of them.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. Banderali G, Martelli A, Landi M et al (2015) Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med 13:327. https://doi.org/10.1186/s12967-015-0690-y

  2. Barros AJD, dos Santos IDS, Victora CG et al (2006) The 2004 pelotas birth cohort: methods and description. Rev Saude Publ 40:402–413. https://doi.org/10.1590/S0034-89102006000300007

  3. Barros FC, Victora CG, Horta BL, Gigante DP (2008) Methodology of the Pelotas birth cohort study from 1982 to 2004–5, Southern Brazil. Rev Saude Publ 42:7–15. https://doi.org/10.1590/S0034-89102008000900003

  4. Barros AJD, Cascaes AM, Wehrmeister FC et al (2011) Tabagismo no Brasil: desigualdades regionais e prevalência segundo características ocupacionais. Cien Saude Colet 16:3707–3716. https://doi.org/10.1590/S1413-81232011001000008

  5. Bettiol H, Barbieri MA, Gomes UA, Andrea M, Goldani MZ, Ribeiro ERO (1998) Saúde perinatal: metodologia e características da população estudada. Revista de Saúde Pública 32(1):18–28. https://doi.org/10.1590/S0034-89101998000100003

  6. Bruin JE, Gerstein HC, Holloway AC (2010) Long-term consequences of fetal and neonatal nicotine exposure: a critical review. Toxicol Sci 116:364–374. https://doi.org/10.1093/toxsci/kfq103

  7. Cardoso VC, Simões VMF, Barbieri MA et al (2007) Profile of three Brazilian birth cohort studies in Ribeirão Preto, SP and São Luís, MA. Braz J Med Biol Res 40:1165–1176. https://doi.org/10.1590/S0100-879X2006005000148

  8. Colman GJ, Joyce T (2003) Trends in smoking before, during, and after pregnancy in ten states. Am J Prev Med 24:29–35. https://doi.org/10.1016/S0749-3797(02)00574-3

  9. da Silva AA, Gomes UA, Bettiol H et al (1992) Correlation between maternal age, social class and smoking, and birth weight. Rev Saude Publ 26:150–154

  10. da Silva AAM, Coimbra LC, da Silva RA et al (2001) Perinatal health and mother-child health care in the municipality of São Luís, Maranhão State, Brazil. Cad Saude Publ 17:1412–1423. https://doi.org/10.1590/S0102-311X2001000600012

  11. da Silva AAM, Batista RFL, Simões VMF et al (2015) Changes in perinatal health in two birth cohorts (1997/1998 and 2010) in São Luís, Maranhão State, Brazil. Cad Saude Publ 31:1437–1450. https://doi.org/10.1590/0102-311x00100314

  12. Dias-Damé JL, Cesar JA (2015) Disparities in prevalence of smoking and smoking cessation during pregnancy: a population-based study. Biomed Res Int 2015:1–8. https://doi.org/10.1155/2015/345430

  13. Ekblad M, Gissler M, Korkeila J, Lehtonen L (2014) Trends and risk groups for smoking during pregnancy in Finland and other Nordic countries. Eur J Public Health 24:544–551. https://doi.org/10.1093/eurpub/ckt128

  14. George L, Granath F, Johansson ALV et al (2006) Environmental tobacco smoke and risk of spontaneous abortion. Epidemiology 17:500–505. https://doi.org/10.1097/01.ede.0000229984.53726.33

  15. Halal IS, Victora CG, Barros FC (1993) Determining factors of smoking habit and its cessation during pregnancy in a urban locality in the southern region of Brazil. Rev Saude Publ 27:105–112. https://doi.org/10.1590/S0034-89101993000200005

  16. Hallal PC, Bertoldi AD, Domingues MR et al (2017) Cohort profile: the 2015 Pelotas (Brazil) birth cohort study. Int J Epidemiol. https://doi.org/10.1093/ije/dyx219

  17. Horta BL, Victora CG, Menezes AM et al (1997) Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol 11:140–151

  18. Instituto Nacional de Câncer (Brasil) (2010) Global adult tobacco survey. Rio de Janeiro

  19. Jamal A, Homa D, O’connor E (2015) Current cigarette smoking among adults—United States, 2005–2014. MMWR Morb Mortal Wkly Rep 64(44):1233–1240. https://doi.org/10.15585/mmwr.mm6444a2

  20. Kuntz B, Lampert T (2016) Social disparities in maternal smoking during pregnancy: comparison of two birth cohorts (1996–2002 and 2003–2012) based on data from the German KiGGS Study. Geburtshilfe Frauenheilkd 76:239–247. https://doi.org/10.1055/s-0042-100207

  21. Levy D, de Almeida LM, Szklo A (2012) The Brazil SimSmoke policy simulation model: the effect of strong tobacco control policies on smoking prevalence and smoking-attributable deaths in a middle income nation. PLoS Med 9:e1001336. https://doi.org/10.1371/journal.pmed.1001336

  22. Levy D, Jiang M, Szklo A et al (2013) Smoking and adverse maternal and child health outcomes in Brazil. Nicotine Tob Res 15:1797–1804. https://doi.org/10.1093/ntr/ntt073

  23. Matijasevich A, Brion M-J, Menezes AM et al (2011) Maternal smoking during pregnancy and offspring growth in childhood: 1993 and 2004 Pelotas cohort studies. Arch Dis Child 96:519–525. https://doi.org/10.1136/adc.2010.191098

  24. Mohsin M, Bauman AE, Forero R (2011) Socioeconomic correlates and trends in smoking in pregnancy in New South Wales, Australia. J Epidemiol Community Health. https://doi.org/10.1136/jech.2009.104232

  25. Ng M, Freeman MK, Fleming TD et al (2014) Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 311:183–192. https://doi.org/10.1001/jama.2013.284692

  26. Reitsma MB, Fullman N, Ng M et al (2017) Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. https://doi.org/10.1016/S0140-6736(17)30819-X

  27. Silveira MF, Matijasevich A, Menezes AMB et al (2016) Secular trends in smoking during pregnancy according to income and ethnic group: four Population-based perinatal surveys in a Brazilian city. BMJ Open 6:1–6. https://doi.org/10.1136/bmjopen-2015-010127

  28. Victora CG, Araújo CLP, Menezes AMB et al (2006) Methodological aspects of the 1993 Pelotas (Brazil) birth cohort study. Rev Saude Publ 40:39–46. https://doi.org/10.1590/S0034-89102006000100008

  29. Victora CG, Joseph G, Silva ICM et al (2018) The inverse equity hypothesis: analyses of institutional deliveries in 286 national surveys. Am. J. PublicHealth. 108(4):464–471. https://doi.org/10.2105/AJPH.2017.304277

  30. Werhmeister FC, Nunes BP, Loret de Mola C et al (2015) Intrauterine exposure to smoking and wheezing in adolescence: the 1993 Pelotas Birth Cohort. J Dev Orig Health Dis 6:217–224. https://doi.org/10.1017/s2040174414000555

  31. WHO (2015) WHO global report on trends in prevalence of tobacco smoking 2015 WHO library cataloguing-in-publication data WHO global report on trends in prevalence of tobacco smoking 2015

  32. World Health Organization (2017) WHO report on the global tobacco epidemic, 2017

  33. Zhang L, González-Chica DA, Cesar JA et al (2011) Tabagismo materno durante a gestação e medidas antropométricas do recém-nascido: um estudo de base populacional no extremo sul do Brasil. Cad Saude Publ 27:1768–1776. https://doi.org/10.1590/S0102-311X2011000900010

Download references

Acknowledgements

We would like to thank all members, mothers, children, and families, of all this birth cohort for their collaboration and all the people involved in data collection and processing.

Funding

Research is supported by Wellcome Trust, “Coordenação de Aperfeiçoamento de Pessoal de Nível Superior” (CAPES), “Conselho Nacional de Desenvolvimento Científico e Tecnológico” (CNPq),” Associação Brasileira de Saúde Coletiva” (ABRASCO), “Fundação de Amparo à Pesquisa do Estado de São Paulo” (FAPESP), “Fundação de Auxílio ao Ensino, Pesquisa e Assistência do HC, FMRP, USP”, “Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul” (FAPERGS), Ministry of Health (Brazil), European Union, National Program for Centers of Excellence - PRONEX (Brazil). None of the funding sources had any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

Author information

Correspondence to Christian Loret de Mola.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests.

Ethics approval and consent to participate

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. For all cohorts, written informed consent was required to participate. In Pelotas, perinatal studies were approved by the ethics committee of the Federal University of Pelotas, in Ribeirão Preto by the ethics committee from the “Hospital Das Clínicas” of the Medical School of Ribeirão Preto, and in São Luíz by the Research Ethics Committee of the University Hospital of the Federal University of Maranhão.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Loret de Mola, C., Cardoso, V.C., Batista, R. et al. Maternal pregnancy smoking in three Brazilian cities: trends and differences according to education, income, and age. Int J Public Health (2020). https://doi.org/10.1007/s00038-019-01328-8

Download citation

Keywords

  • Smoke
  • Pregnancy
  • Trend
  • Population-based
  • Schooling
  • Income