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Smoking in Pregnancy in West Virginia: Does Cessation/Reduction Improve Perinatal Outcomes?

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Abstract

To determine if pregnant women decreasing/quitting tobacco use will have improved fetal outcomes. Retrospective analysis of pregnant smokers from 6/1/2006–12/31/2007 who received prenatal care and delivered at a tertiary medical care center in West Virginia. Variables analyzed included birth certificate data linked to intervention program survey data. Patients were divided into four study groups: <8 cigarettes/day–no reduction, <8 cigarettes/day–reduction, ≥8 cigarettes/day–no reduction, and ≥8 cigarettes/day–reduction. Analysis performed using ANOVA one-way test for continuous variables and Chi-square for categorical variables. Inclusion criteria met by 250 patients. Twelve women (4.8%) quit smoking; 150 (60%) reduced; 27 (10.8%) increased; and 61 (24.4%) had no change. Comparing the four study groups for pre-term births (<37 weeks), 25% percent occurred in ≥8 no reduction group while 10% occurred in ≥8 with reduction group (P = 0.026). The high rate of preterm birth (25%) in the non-reducing group depended on 2 factors: (1) ≥8 cigarettes/day at beginning and (2) no reduction by the end of prenatal care. Finally, there was a statistically significant difference in birth weights between the two groups: ≥8 cigarettes/day with no reduction (2,872.6 g) versus <8 cigarettes/day with reduction (3,212.4 g) (P = 0.028). Smoking reduction/cessation lowered risk of pre-term delivery (<37 weeks) twofold. Encouraging patients who smoke ≥8 cigarettes/day during pregnancy to decrease/quit prior to delivery provides significant clinical benefit by decreasing the likelihood of preterm birth. These findings support tobacco cessation efforts as a means to improve birth outcome.

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Acknowledgments

The authors thank Suzanne Kemper, M.P.H., for developing the smoking cessation program data collection instrument and managing the data collection process for program data and Anne Matics, R.N.C, M.S., for providing access to program data. This study is supported by the West Virginia Department of Health and Human Resources-Division of Tobacco Prevention.

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Authors and Affiliations

  1. Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, 3211 MacCorkle Ave, SE, Charleston, WV, 25302, USA

    Dara J. Seybold & Mike Broce

  2. Department of Obstetrics and Gynecology, Charleston Area Medical Center, Charleston, WV, USA

    Eric Siegel & Joseph Findley

  3. Department of Obstetrics and Gynecology, West Virginia University-Charleston, Charleston, WV, USA

    Byron C. Calhoun

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  1. Dara J. Seybold
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  2. Mike Broce
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  5. Byron C. Calhoun
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Correspondence to Dara J. Seybold.

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Seybold, D.J., Broce, M., Siegel, E. et al. Smoking in Pregnancy in West Virginia: Does Cessation/Reduction Improve Perinatal Outcomes?. Matern Child Health J 16, 133–138 (2012). https://doi.org/10.1007/s10995-010-0730-4

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