Skip to main content

Advertisement

SpringerLink
Log in

Disparities in Maternal Child and Health Outcomes Attributable to Prenatal Tobacco Use

  • Original Paper
  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives Previous estimates of smoking-attributable adverse outcomes, such as preterm births (PTBs), low birth weight (LBW) and Sudden Infant Death Syndrome (SIDs) generally do not address disparities by maternal age, racial/ethnic group or socioeconomic status (SES). This study develops estimates of smoking-attributable PTB, LBW and SIDS for the US by age, SES and racial/ethnic groupings. Methods Data on the number of births and the prevalence of PTB, LBW and SIDS were used to develop the number of outcomes by age, race/ethnicity, and SES. The prevalence of prenatal smoking by age, race/ethnic and education and the relative risk of outcomes for smokers were used to calculate smoking-attributable fractions of outcomes. Results Prenatal smoking among ages 15–24 is above 12 %, with 20–24 year olds representing at least 35 % of PTB, LBW SIDS cases. Women with a high school education or less represented more than 50 % of PTB and LBW births, and 44 % of SIDS cases. While non-Hispanic Whites had the majority of smoking-attributable outcomes, non-Hispanic Blacks represented a disproportionately high percentage of PTBs (18 %), LBW births (22 %), and SIDS cases (13 %). Conclusions Reducing prenatal smoking has the potential to reduce adverse birth outcomes and costs with long-term implications, especially among the young, non-Hispanic Blacks and those of lower SES. Stricter tobacco control policies, especially higher cigarette taxes, higher minimum purchase ages for tobacco and improved cessation interventions can help reduce disparities and the cost to insurers, especially public costs through Medicaid.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cnattingius, S. (2004). The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine and Tobacco Research, 6(Suppl 2), S125–S140. doi:10.1080/14622200410001669187RUXN36F9J24X6H0N.

    Article  PubMed  Google Scholar 

  2. Dietz, P. M., England, L. J., Shapiro-Mendoza, C. K., et al. (2010). Infant morbidity and mortality attributable to prenatal smoking in the U.S. American Journal of Preventive Medicine, 39(1), 45–52. doi:10.1016/j.amepre.2010.03.009.

    Article  PubMed  Google Scholar 

  3. USDHHS. (2004). The 2004 United States surgeon general’s report: The health consequences of smoking. In H. Oosa (Ed.) National center for chronic disease prevention and health promotion. Atlanta (GA), p. 910.

  4. Miller, D. P., Villa, K. F., Sivapathasundaram, D., et al. (2001). Birth and first-year costs for mothers and infants attributable to maternal smoking. Nicotine and Tobacco Research, 3(1), 25–35. doi:10.1080/14622200125305.

    Article  CAS  PubMed  Google Scholar 

  5. Adams, E. K., Markowitz, S., Dietz, P. M., et al. (2013). Expansion of medicaid covered smoking cessation services: Maternal smoking and birth outcomes. Medicare and Medicaid Research Review, 3(3), E1–E23.

    Article  Google Scholar 

  6. Sonfield, A., Kost, K., Gold, R. B., et al. (2011). The public costs of births resulting from unintended pregnancies: National and state-level estimates. Perspectives on Sexual and Reproductive Health, 43(2), 94–102. doi:10.1363/4309411.

    Article  PubMed  Google Scholar 

  7. AHRQ. (2008). Center for delivery, organization and markets, helath care cost and utilitization poject, nationwide utilization sample.

  8. Levy, D., Jiang, M., Szklo, A., et al. (2013). Smoking and adverse maternal and child health outcomes in Brazil. Nicotine and Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 15(11), 1797–1804. doi:10.1093/ntr/ntt073.

    Article  Google Scholar 

  9. Dietz, P. M., Homa, D., England, L. J., et al. (2011). Estimates of nondisclosure of cigarette smoking among pregnant and nonpregnant women of reproductive age in the United States. American Journal of Epidemiology, 173(3), 355–359. doi:10.1093/aje/kwq381.

    Article  PubMed  Google Scholar 

  10. Tong, V. T., Dietz, P. M., Farr, S. L., et al. (2013). Estimates of smoking before and during pregnancy, and smoking cessation during pregnancy: Comparing two population-based data sources. Public Health Reports, 128(3), 179–188.

    PubMed Central  PubMed  Google Scholar 

  11. Tong, V. T., Dietz, P. M., Morrow, B., et al. (2013). Trends in smoking before, during, and after pregnancy—Pregnancy risk assessment monitoring system, united States, 40 sites, 2000–2010. MMWR Surveill Summ, 62(6), 1–19.

    PubMed  Google Scholar 

  12. Higgins, S. T., Heil, S. H., Badger, G. J., et al. (2009). Educational disadvantage and cigarette smoking during pregnancy. Drug and Alcohol Dependence, 104(Suppl 1), S100–S105.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Tong, V. T., Dietz, P. M., England, L. J., et al. (2011). Age and racial/ethnic disparities in prepregnancy smoking among women who delivered live births. Preventing Chronic Disease., 8(6), A121.

    PubMed Central  PubMed  Google Scholar 

  14. Curtin, S. C., Abma, J. C., Ventura, S. J., et al. (2013). Pregnancy rates for U.S. women continue to drop. NCHS Data Brief, 136, 1–8.

    PubMed  Google Scholar 

  15. Salihu, H. M., Aliyu, M., Pierre-Louis, B. J., et al. (2003). Levels of excess infant death atrributable to maternal smoking during pregnancy in the United States. Maternal and Child Health Journal, 7(4), 219–227.

    Article  PubMed  Google Scholar 

  16. Levin, M. L. (1953). The occurrence of lung cancer in man. Acta Unio Internationalis Contra Cancrum, 9, 531–541.

    CAS  PubMed  Google Scholar 

  17. Lilienfeld, A., & Lilienfeld, D. (1980). Foundations of epidemiology. New York: Oxford University Press.

    Google Scholar 

  18. CDC. (2008). Cigarette smoking among adults—United States, 2007. Morbidity and Mortality Weekly Report, 57(45), 1221–1226.

    Google Scholar 

  19. Murphy, S. L., Xu, J., & Kochanek, K. D. (2013). Deaths: Final data for 2010. National vital statistics reports: From the centers for disease control and prevention, national center for health statistics. National Vital Statistics System, 61(4), 1–117.

    Google Scholar 

  20. Anderka, M., Romitti, P. A., Sun, L., Druschel, C., Carmichael, S., & Shaw, G. (2010). Patterns of tobacco exposure before and during pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 89(4), 505–514.

    Article  PubMed  Google Scholar 

  21. Castles, A., Adams, E. K., Melvin, C. L., et al. (1999). Effects of smoking during pregnancy. Five meta-analyses. American Journal of Preventive Medicine, 16(3), 208–215.

    Article  CAS  PubMed  Google Scholar 

  22. Aliyu, M. H., Lynch, O., Saidu, R., et al. (2010). Intrauterine exposure to tobacco and risk of medically indicated and spontaneous preterm birth. American Journal of Perinatology, 27(5), 405–410. doi:10.1055/s-0029-1243316.

    Article  PubMed  Google Scholar 

  23. DiFranza, J. R., & Lew, R. A. (1995). Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. Journal of Family Practice, 40(4), 385–394.

    CAS  PubMed  Google Scholar 

  24. da Veiga, P., & Wilder, R. (2008). Maternal smoking during pregnancy and birthweight: A propensity score matching approach. Maternal and Child Health Journal, 12(2), 194–203.

    Article  PubMed  Google Scholar 

  25. Chertok, I. R., & Archer, S. H. (2015). Evaluation of a midwife- and nurse-delivered 5 A’s prenatal smoking cessation program. J Midwifery Womens Health, 60(2), 175–181. doi:10.1111/jmwh.12220.

    Article  PubMed  Google Scholar 

  26. Aliyu, M. H., Lynch, O., Wilson, R. E., et al. (2009). Association between tobacco use in pregnancy and placenta-associated syndromes: A population-based study. Archives of gynecology and obstetrics, 283(4), 729–734.

    Article  Google Scholar 

  27. van den Berg, G., van Eijsden, M., Galindo-Garre, F., et al. (2013). Smoking overrules many other risk factors for small for gestational age birth in less educated mothers. Early Human Development, 89(7), 497–501. doi:10.1016/j.earlhumdev.2013.03.007.

    Article  PubMed  Google Scholar 

  28. van den Berg, G., van Eijsden, M., Vrijkotte, T. G., et al. (2012). Educational inequalities in perinatal outcomes: The mediating effect of smoking and environmental tobacco exposure. PLoS One, 7(5), e37002. doi:10.1371/journal.pone.0037002.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Zhang, K., & Wang, X. (2013). Maternal smoking and increased risk of sudden infant death syndrome: A meta-analysis. Legal Medicine, 15(3), 115–121. doi:10.1016/j.legalmed.2012.10.007.

    Article  CAS  PubMed  Google Scholar 

  30. Mitchell, E. A., & Milerad, J. (2006). Smoking and the sudden infant death syndrome. Reviews on Environmental Health, 21(2), 81–103.

    Article  CAS  PubMed  Google Scholar 

  31. Centers for Disease Control and Prevention. Pregnancy Risk Assessment Monitoring System (PRAMS): CPONDER. (2014). http://www.cdc.gov/prams/cponder.htm. Accessed October 17, 2014.

  32. Pickett, K. E., Luo, Y., & Lauderdale, D. S. (2005). Widening social inequalities in risk for sudden infant death syndrome. American Journal of Public Health, 95(11), 1976–1981. doi:10.2105/AJPH.2004.059063.

    Article  PubMed Central  PubMed  Google Scholar 

  33. MacDorman, M. F., Mathews, T. J. (2011). Understanding racial and ethnic disparities in U.S. infant mortality rates. In M. D. Hyattsville (Ed.) Statistics NCfH, p. 7.

  34. Petrou, S., & Khan, K. (2012). Economic costs associated with moderate and late preterm birth: Primary and secondary evidence. Seminars in Fetal and Neonatal Medicine, 17(3), 170–178. doi:10.1016/j.siny.2012.02.001.

    Article  PubMed  Google Scholar 

  35. Petrou, S., Sach, T., & Davidson, L. (2001). The long-term costs of preterm birth and low birth weight: Results of a systematic review. Child Care, Health and Development, 27(2), 97–115.

    Article  CAS  PubMed  Google Scholar 

  36. Institute of Medicine. (2007). Preterm birth: Causes, consequences, and prevention. In R. E. B. A. Behrman (Ed.) Washington (DC): National Academies Press.

  37. Schmitt, S. K., Sneed, L., & Phibbs, C. S. (2006). Costs of newborn care in California: A population-based study. Pediatrics, 117(1), 154–160. doi:10.1542/peds.2005-0484.

    Article  PubMed  Google Scholar 

  38. Russell, R. B., Green, N. S., Steiner, C. A., et al. (2007). Cost of hospitalization for preterm and low birth weight infants in the United States. Pediatrics, 120(1), e1–e9. doi:10.1542/peds.2006-2386.

    Article  PubMed  Google Scholar 

  39. Wolke, D., Chernova, J., Eryigit-Madzwamuse, S., et al. (2013). Self and parent perspectives on health-related quality of life of adolescents born very preterm. The Journal of pediatrics., 163(4), 1020-6 e2. doi:10.1016/j.jpeds.2013.04.030.

    Article  PubMed  Google Scholar 

  40. Ringel, J. S., & Evans, W. N. (2001). Cigarette taxes and smoking during pregnancy. American Journal of Public Health, 91(11), 1851–1856.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Levy, D. E., & Meara, E. (2006). The effect of the 1998 master settlement agreement on prenatal smoking. Journal of Health Economics, 25(2), 276–294. doi:10.1016/j.jhealeco.2005.07.006.

    Article  PubMed  Google Scholar 

  42. Markowitz, S. (2008). The effectiveness of cigarette regulations in reducing cases of sudden infant death syndrome. Journal of Health Economics, 27(1), 106–133. doi:10.1016/j.jhealeco.2007.03.006.

    Article  PubMed  Google Scholar 

  43. Adams, E. K., Markowitz, S., Kannan, V., et al. (2012). Reducing prenatal smoking: The role of state policies. American Journal of Preventive Medicine, 43(1), 34–40. doi:10.1016/j.amepre.2012.02.030.

    Article  PubMed  Google Scholar 

  44. Colman, G., Grossman, M., & Joyce, T. (2003). The effect of cigarette excise taxes on smoking before, during and after pregnancy. Journal of Health Economics, 22(6), 1053–1072. doi:10.1016/j.jhealeco.2003.06.003.

    Article  PubMed  Google Scholar 

  45. Tong, V. T., Dietz, P. M., Rolle, I. V., et al. (2014). Clinical interventions to reduce secondhand smoke exposure among pregnant women: A systematic review. Tobacco Control,. doi:10.1136/tobaccocontrol-2013-051200.

    Google Scholar 

  46. Petersen, R., Garrett, J. M., Melvin, C. L., et al. (2006). Medicaid reimbursement for prenatal smoking intervention influences quitting and cessation. Tobacco Control, 15(1), 30–34. doi:10.1136/tc.2005.012187.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  47. Kim, S. Y., England, L. J., Kendrick, J. S., et al. (2009). The contribution of clinic-based interventions to reduce prenatal smoking prevalence among US women. American Journal of Public Health, 99(5), 893–898. doi:10.2105/AJPH.2008.144485.

    Article  PubMed Central  PubMed  Google Scholar 

  48. Lumley, J., Chamberlain, C., Dowswell, T., et al. (2009). Interventions for promoting smoking cessation during pregnancy. Cochrane Database System Review,. doi:10.1002/14651858.CD001055.pub3.

    Google Scholar 

  49. Institute of Medicine. (2015). Public health implications of raising the minimum age of legal access to tobacco products. Washington, DC: The National Academies Press.

    Google Scholar 

  50. Yan, J., & Groothuis, P. A. (2014). Timing of prenatal smoking cessation or reduction and infant birth weight: Evidence from the United Kingdom millennium cohort study. Maternal and Child Health Journal,. doi:10.1007/s10995-014-1516-x.

    PubMed  Google Scholar 

  51. Bailey, B. A., & McCook, J. G. (2011). Quitting smoking during pregnancy and birth outcomes: Evidence of gains following cessation by third trimester. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 40(S1), S98–S99. doi:10.1111/j.1552-6909.2011.01243.x.

    Article  Google Scholar 

  52. Yang, Q., Wen, S. W., Phillips, K., et al. (2009). Comparison of maternal risk factors between placental abruption and placenta previa. American Journal of Perinatology, 26(4), 279–286. doi:10.1055/s-0028-1103156.

    Article  CAS  PubMed  Google Scholar 

  53. Bouyer, J., Rouxel, A., & Job-Spira, N. (2001). Smoking cessation or reduction in women attempting to conceive after ectopic pregnancy. European Journal of Epidemiology, 17(12), 1063–1066.

    Article  CAS  PubMed  Google Scholar 

  54. Karaer, A., Avsar, F. A., & Batioglu, S. (2006). Risk factors for ectopic pregnancy: A case-control study. The Australian and New Zealand Journal Of Obstetrics and Gynaecology, 46(6), 521–527. doi:10.1111/j.1479-828X.2006.00653.x.

    Article  PubMed  Google Scholar 

  55. Bureau USC. (2013) Household income table of contents. In Current population survey, 2014 annual social and economic supplement. U.S. Census Bureau, 2014. Accessed October 2, 2014.

Download references

Acknowledgments

The project has been funded with Federal funds from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN261201000043C and grant R01DA036497-01. We would also like to thank the Institute of Medicine of the National Academy of Sciences for partial funding.

Author information

Authors and Affiliations

  1. Georgetown University, Washington, DC, USA

    Mary Katherine Mohlman & David T. Levy

Authors
  1. Mary Katherine Mohlman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David T. Levy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David T. Levy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohlman, M.K., Levy, D.T. Disparities in Maternal Child and Health Outcomes Attributable to Prenatal Tobacco Use. Matern Child Health J 20, 701–709 (2016). https://doi.org/10.1007/s10995-015-1870-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1870-3

Keywords

Search

Navigation