Correlates of smoking during pregnancy

Background: Preterm births and low birth weight are major public health problems, and African Americans are disproportionately affected by it. While smoking is one of the known risk factors contributing to the problem, health care providers are challenged with an effective way of screening and identifying smokers during pregnancy. This study examined correlates for smoking during the first trimester of pregnancy among African American women.

Method: Anonymous survey was administered to African-American women attending their first prenatal visit (N=388) in an urban hospital-based obstetric clinic. Psychosocial risk factors and life style behaviors were assessed using standardized measures. Multiple logistic regression was conducted to determine predictors of smoking. Results: The majority of the study population reported to be single (79%) and unemployed (50%). Over a quarter of the women reported current smoking (within past seven days) and 42% displayed depressive symptoms. Adjusted multiple logistic regression analysis showed that age, education, employment status, acohol consumption and depression were significant predictors for smoking during pregnancy. Compared to non-smokers, women who smoked were nearly two times more likely to be depressed and 3.2 times to be unemployed. Conclusion: Due to the stigma attached to smoking during pregnancy, obtaining candid information may be challenging. However, the presence of depressive symptoms or unemployment may alert health care professionals to further query women regarding their smoking habits. Further studies need to be conducted to validate this finding.