203187 Smoking during pregnancy and a randomized trial anti-smoking intervention during pregnancy in Romania

Monday, November 9, 2009

Cristian Meghea, PhD , Institute for Health Care Studies, Michigan State University, East Lansing, MI
Smoking during pregnancy is the single most modifiable risk factor of poor birth outcomes, issue of particular relevance in lower-income developing countries. Pregnancy is one of the most opportune times to initiate smoking cessation. This study will describe the design and implementation of a randomized trial anti-smoking intervention during pregnancy in Cluj-Napoca, Romania, one of the few in Eastern Europe. It will also describe in detail smoking during pregnancy.

The data is in the process of being collected as part of a two-year funded research project running between 2008 and 2010. A risk screener is being applied with the target of gathering a sample of approximately 1000 pregnant women during their prenatal visit in two urban clinics in Romania. The screener documents smoking in detail including prevalence, severity, attitudes and knowledge about smoking, information about spousal smoking

Relying on a database in progress (N=210), preliminary results indicate that 14% of the pregnant women smoke. Among smokers, over 45% smoke more than half a pack per day. Over 20% smoke more than one pack per day. Seventy-six percent of the smokers tried to quit during pregnancy. Almost 83% agree that smoking during pregnancy may have negative effects on the fetus and cause complications at delivery.

While the share of smokers seems to be smaller than other similar studies have indicated, the severity of the habit is quite high among pregnant women. Pregnant women seem very committed to quit. Specialized help may improve their chances.

Learning Objectives:
1. Recognize smoking during pregnancy as the single most modifiable risk factor of poor birth outcomes 2. Describe the design and implementation of a randomized trial anti-smoking intervention during pregnancy 3. Assess smoking during pregnancy, including prevalence, severity, attitudes and knowledge about smoking, information about spousal smoking in a relatively large sample of pregnant women in Romania

Keywords: Pregnancy Outcomes, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: QUALIFICATIONS Center for Health Policy and Public Health, Institute for Social Research, Babes-Bolyai University, Cluj-Napoca, Romania Scientific Researcher III, since July 2008 • Lead externally-funded health policy and public health research projects, conduct health policy analyses and public health research for decision-makers at local, state, and national levels • Present work at professional meetings • Write research papers for submission to peer-reviewed journals Institute for Health Care Studies, Michigan State University, East Lansing, MI, USA Assistant Professor, since August 2006 • Write research papers for submission to peer-reviewed journals • Statistical analysis using SAS and Stata software • Lead externally-funded health services research projects, conduct health policy analyses and health policy research for decision-makers at local, state, and national levels • Evaluate and review economic data for use in forecasting, planning and analysis health care costs, including federal and state legislation, economic policy and fiscal policy that affect health care in the state of Michigan and nationally • Present work at professional meetings Relevant research grants:  Principal Investigator. “Maternal and Child Health in Romania: a study on smoking during pregnancy, depression, stress, other risk factors, and a smoking cessation intervention.” 2008-2010. ($205,000. Ministry of Education, Research and Youth, Romania)  Principal Investigator. “Effect of Enhanced Home Visit on Infant Health.” This project evaluates the advantage of an enhanced prenatal services Medicaid program using nurse-CHW (community-health-worker) home visiting teams in improving child health in a cost effective way. 2008-2009 ($46,530 Blue Cross Blue Shield of Michigan Foundation)  Co – Principal Investigator. “Michigan Family Medicaid Project (MFMP),” joint work with the state of Michigan to develop a new system of care for Medicaid women and infants. 2006-2007 ($600,000), renewed for 2007-2008 ($750,921) and for 2008-2009 ($321,000) Michigan Department of Community Health, Grand Rapids Medical Education & Research Center, Kent County Health Publications: “Who Participates in State Sponsored Medicaid Enhanced Prenatal Services?” with Lee Anne Roman et al. Maternal and Child Health Journal. Forthcoming, 2009 “Maternal and Child Health in Low Income Families.” Lead author, with Lee Anne Roman et al. In New Directions in Family Research (P.S. Whitten, J.L. Bokemeier, H.E. Fizgerald, eds.), Michigan State University Family Research Initiative. 2008. Working Papers “Smoking among Pregnant Women with Medicaid Insurance: Are Mental Health Factors Related?” Lead author: Jodi Holtrop Summers. “The effect of a nurse - community health worker home visiting program on the health of newborn children” “Identifying low-income pregnant women at highest risk using latent class modelling and cluster analysis” “Abuse Among Pregnant Medicaid Insured Women in Michigan.” Lead author: Jennifer Raffo. “Risk Factors for Rapid Repeat Birth and Pregnancy in Medicaid Insured Women.” Lead author: Joel Maurer. “Enhanced Prenatal Services and Birth Outcomes among Medicaid Insured Women.” Lead author: Julie Bodwell.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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