205307 Smoking and stressful life events during pregnancy, Maryland, 2001-2007

Monday, November 9, 2009: 9:20 AM

Lee Hurt, MS, MPH , Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Diana Cheng, MD , Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Background: Smoking during pregnancy is a risk factor for poor birth outcomes. The goal of this analysis was to understand the associations between smoking and stressful life events during pregnancy.

Methods: Data were obtained from a stratified random sample of 10898 mothers who delivered live infants during the years 2001-2007 and completed the Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Descriptive analyses were performed using SAS. Smoking during pregnancy was based on the number of cigarettes smoked daily during the last 3 months of pregnancy. Stressful life events were those that occurred in the 12 months before delivery.

Results: In Maryland, of the 9.5% of mothers who reported smoking during pregnancy, 4.5% smoked <= cigarettes/day (lighter smokers), and 5.0% smoked >5 cigarettes/day (heavier smokers). Smoking was most prevalent among White non-Hispanics.

Twenty-one percent of heavier smokers experienced a large number (6-13) of stressful events compared to lighter smokers (11.2%) and nonsmokers (4.4%). Smokers were significantly more likely than nonsmokers to report experiencing all types of stressful events surveyed, including: separation/divorce, inability to pay bills, physical fight, jail or partner in jail, homelessness, and job loss.

There were racial disparities, especially among heavier smokers. Black heavier smokers were significantly more likely to report homelessness (Black:28.0%; White:9.1%), and physical fights (Black:33.0%; White:8.9%).

Discussion: This analysis indicates that smoking during pregnancy is associated with increased stressful life events. Multiple serious difficulties disproportionately face women that smoke during pregnancy. Knowledge about these associated factors may affect the design of smoking cessation programs.

Learning Objectives:
1. Describe the association between smoking and stressful life events during pregnancy among women in Maryland. 2. Identify different subpopulations of pregnant smokers at increased risk for stressful life events.

Keywords: Stress, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have an MPH in epidemiology and am a DrPH candidate. I have presented two posters at prior APHA conferences. I am the epidemiologist on the Maryland PRAMS Program.
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.