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The relationship between maternal depression and smoking cessation during pregnancy—a cross-sectional study of pregnant women from 15 European countries

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Abstract

Epidemiologic studies have reported an association between depression and continuing smoking during pregnancy. However, differences in study design and methodology challenge study comparability. The purpose of this study was to examine the relationship between maternal depression and continuing smoking among pregnant European women while adjusting for maternal characteristics. This multinational, web-based study evaluated pregnant women in 15 European countries recruited from October 2011 to February 2012. Data on depression status, smoking habits, maternal socio-demographic characteristics, and life-style factors were collected via an anonymous online questionnaire. Associations were estimated with logistic regression. Of 4,295 women included, 1,481 (34.5 %) reported smoking before pregnancy, and 391 (26.4 %) continued smoking during pregnancy whereof 127 (32.5 %) were depressed. The association between depression and continuing smoking during pregnancy were uniform across the European countries (OR 2.02, 95 % CI 1.50–2.71), with about twice the prevalence of continuing smoking among the depressed. There was a strong relationship between continuing smoking in pregnancy and low education level (OR 4.46, 95 % CI 2.72–7.32), which coincided with risky pregnancy behavior such as failure to attend pregnancy/birth preparation courses (OR 1.80, 95 % CI 1.19–2.72) and follow recommended use of folic acid (OR 1.81, 95 % CI 1.23–2.65). Women who perceived the risk for the fetus of continued smoking during pregnancy as higher were the least likely to continue smoking during pregnancy (OR 0.72, 95 % CI 0.68–0.77). This underlines the clustering of risk in some pregnant women, and the results should guide antenatal care of depressed women struggling to quit smoking during pregnancy.

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Acknowledgments

The study has received financial support by the Norwegian Research Council (grant no. 216771/F11) and the Foundation of Promotion of Norwegian Pharmacies and the Norwegian Pharmaceutical Society (non-profit organizations). We thank the Scientific Board of OTIS and ENTIS who reviewed the study protocol, all website providers who contributed to the recruitment phase, the national coordinators of the study (Twigg MJ, Zagorodnikova K, Moretti ME, Drozd M, Panchaud A, Hameen-Anttila K, Rieutord A, Gjergja Juraski R, Odalovic M, Kennedy D, Rudolf G, Juch H, Passier JLM, and Björnsdóttir I), and all participating women.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Pharmacy, University of Oslo, Oslo, Norway

    Janne Smedberg, Angela Lupattelli & Hedvig Nordeng

  2. Research and Development, Sahlgrenska University Hospital, Gothenburg, Sweden

    Ann-Charlotte Mårdby

  3. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

    Simon Øverland & Hedvig Nordeng

  4. Department of Psychosocial Science, University of Bergen, Bergen, Norway

    Simon Øverland

  5. Department of Pharmacy, School of Pharmacy, University of Oslo, P.O. Box 1068 Blindern, 0316, Oslo, Norway

    Janne Smedberg

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Smedberg, J., Lupattelli, A., Mårdby, AC. et al. The relationship between maternal depression and smoking cessation during pregnancy—a cross-sectional study of pregnant women from 15 European countries. Arch Womens Ment Health 18, 73–84 (2015). https://doi.org/10.1007/s00737-014-0470-3

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