Tobacco and pregnancy outcomes in a rural area of Bangladesh

BACKGROUND: Low birth weight (LBW) is strongly associated with neonatal mortality and morbidity. One well-established risk factor for LBW is tobacco smoking. Tobacco chewing is very common in rural Bangladesh. The general paucity of information on this issue prompted the researchers to conduct this study.

METHODS: 350 pregnant women in Gonoahasthaya Kendra service area (a NGO) were followed up from conception to delivery. Pregnant mothers and their husbands were interviewed about their chewing/smoking habits. The relationship between chewing/smoking habits and ‘low birth weight' and ‘preterm delivery' were studied.

RESULTS: The percentage of maternal smoking (cigarettes, bidi) in this community was very low (2.3%) but the prevalence of tobacco chewing was very high (53.4%) in the form of zarda (sweetened tobacco), ala-pata (raw tobacco) and gul (dried/powdered) with betel-leaf and areca nut. About half of the fathers (47.1%) were found to be active smokers (cigarettes/bidi) in this study. LBW was significantly higher in maternal tobacco chewing group (OR=2.2, 95% CI=1.28–3.86, p<0.05) but not in paternal smoking group (OR=1.3, 95% CI=0.6-2.9, p=0.4). Preterm delivery rate was not significantly different in both the maternal tobacco chewing and paternal smoking groups.

CONCLUSION: The study found that maternal tobacco chewing is a risk factor for LBW in this part of the world. During antenatal care visits, health personnel should educate the expectant mothers about the side effects, not only of cigarettes and bidi but also of tobacco chewing. Further study is needed to validate these study findings.