Investigating the Role of Race and Stressful Life Events on the Smoking Patterns of Pregnant and Postpartum Women in the United States: A Multistate Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) Analysis
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Published:2023-09-22
Issue:S1
Volume:27
Page:166-176
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ISSN:1092-7875
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Container-title:Maternal and Child Health Journal
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language:en
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Short-container-title:Matern Child Health J
Author:
Yakubu Rauta AverORCID, Ajayi Kobi V., Dhaurali Shubhecchha, Carvalho Keri, Kheyfets Anna, Lawrence Blessing Chidiuto, Amutah-Onukagha Ndidiamaka
Abstract
Abstract
Objective
To examine the smoking patterns of women who experienced stressful life events and the impact of racial disparities on the relationship between stressful life events, and prenatal/ postpartum smoking.
Methods
The study analyzed data from the Pregnancy Risk Assessment Monitoring System Phase 8 (2016–2018) survey across five states (CT, LA, MA, MO, WI). Four stressful life event categories were created using thirteen affiliated questions: financial, trauma, partner, and emotional. We assessed: 1) the association between smoking and stressful life events, 2) the impact of race on the relation between smoking and stressful life events, and 3) the long-term effects of smoking on health by assessing the association between smoking and maternal morbidity. Bivariate statistics and multivariate Poisson regression models were conducted.
Results
A total of 24,209 women from five states were included. 8.9% of respondents reported smoking during pregnancy, and 12.7% reported smoking postpartum. There was a significant association between all stressful life events and smoking. Trauma stressful life event had the strongest association with smoking during pregnancy (adjusted PR=2.01; CI: 1.79-2.27) and postpartum (adjusted PR= 1.80; CI: 1.64-1.98). Race and stressful life event interaction effects on smoking had varied significant findings, but at least one racial/ ethnic minority group (Black, Hispanic, Asian) had a higher smoking prevalence than non-Hispanic White per stressful life event category. Lastly, the prevalence of maternal morbidity was higher for smoking during pregnancy (adjusted PR= 1.28; CI: 1.19-1.38) and postpartum (adjusted PR= 1.30; CI: 1.22-1.38) compared to no smoking.
Conclusions for Practice
Culturally congruent, multi-disciplinary care teams are needed to address both clinical and social needs to reduce stressful life events and smoking. Screenings for stress should be standardized with a referral system in place to provide ongoing support.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health,Epidemiology
Reference42 articles.
1. Ahluwalia, I. B., Merritt, R., Beck, L. F., & Rogers, M. (2001). Multiple lifestyle and psychosocial risks and delivery of small for gestational age infants. Obstetrics and Gynecology, 97(5 Pt 1), 649–656. https://doi.org/10.1016/s0029-7844(01)01324-2. 2. Alhusen, J. L., Geller, R., Jellig, J., Budhathoki, C., & Decker, M. (2018). Intimate partner violence, small for gestational age birth, and cigarette smoking in the pregnancy risk Assessment Monitoring System. Journal of Women’s Health, 27(4), 458–465. https://doi.org/10.1089/jwh.2017.6322. 3. Allen, A. M., Jung, A. M., Lemieux, A. M., Alexander, A. C., Allen, S. S., Ward, K. D., & al’Absi, M. (2019). Stressful life events are associated with perinatal cigarette smoking. Preventive Medicine, 118, 264–271. https://doi.org/10.1016/j.ypmed.2018.11.012. 4. American College of Obstetricians and Gynecologists. (2018). ACOG committee opinion no. 757: Screening for perinatal depression. Obstetrics and Gynecology, 132(5), e208–e212. https://doi.org/10.1097/AOG.0000000000002927. 5. Azagba, S., Manzione, L., Shan, L., & King, J. (2020). Trends in smoking during pregnancy by socioeconomic characteristics in the United States, 2010–2017. BMC Pregnancy and Childbirth, 20(1), 52. https://doi.org/10.1186/s12884-020-2748-y.
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