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Smoking during pregnancy: Patterns of use and maternal and birth outcomes among Hispanic women
Smoking during pregnancy is one of the most important modifiable behaviors to affect pregnancy outcome. Smoking patterns vary widely among U.S. Hispanic women according to country of origin, and Puerto Rican women have the highest rates of smoking during pregnancy compared to Mexican women and Hispanics from other countries. Therefore, it is important to examine the attributes of women who quit smoking at pregnancy onset as well as the maternal and fetal outcomes associated with continued smoking among Puerto Rican women. The first study of this dissertation examined the attributes of women who quit smoking at pregnancy onset in a population of predominantly Puerto Rican prenatal care patients. Among women who smoked prior to pregnancy, non-Puerto Rican Hispanic ethnicity, being born outside the U.S., and having a family history of type 2 diabetes were significantly associated with quitting smoking at pregnancy onset, while pre pregnancy daily marijuana use, heavy smoking, having a prior birth, and a high stress score were inversely associated with quitting smoking. Findings may be used to tailor cessation messages and target women at risk of continued smoking during pregnancy. The second study of this dissertation examined the association between smoking and risk of gestational diabetes (GDM) and abnormal glucose tolerance (AGT). This study adds to sparse literature on smoking and abnormal glucose tolerance. Smoking in pre, early or mid pregnancy was not associated with risk of GDM but confidence intervals were wide due to small number of cases. Smoking was associated with a suggestion of decreased risk of AGT, although not significant in multivariate models. Additional research is needed to better understand the effect of smoking on plasma glucose levels and risk of AGT during pregnancy. The third study of this dissertation evaluated the association between smoking during pregnancy and risk of preterm birth and small-for-gestational-age (SGA). The strengths of this study included the assessment of smoking at two time points in pregnancy and the evaluation of preterm birth subtypes. Results supported prior findings in largely non-Hispanic white populations that smoking during pregnancy increases the risk of preterm birth and SGA.
Haskins, Amy E, "Smoking during pregnancy: Patterns of use and maternal and birth outcomes among Hispanic women" (2008). Doctoral Dissertations Available from Proquest. AAI3336960.