239866 Birth outcomes among mothers reporting smoking before pregnancy and use of fertility treatments, Maryland, 2001-2009

Monday, October 31, 2011: 9:00 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: Our goal was to understand associations between birth outcomes among mothers who reported using Fertility Treatments (FT) and smoking prepregnancy. Methods: Data were obtained from a stratified random sample of 14,194 mothers who delivered live infants 2001-2009 and completed the Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Logistic regression analyses were performed using SAS. FT includes fertility drugs, insemination techniques, assisted reproductive technology or other medical treatments. Smoking prepregnancy was based on any smoking during the 3 months prepregnancy. Analysis of birth outcomes was restricted to mothers with singleton or twin births (all 3+ multiples were low birth weight [LBW,<2500g] and preterm [<37weeks]). Results: Five percent of mothers reported using FT: most were White non-Hispanic (70%), 30+ years old (74%), and college graduates (68%). Of mothers reporting FT use, 5% smoked prepregnancy. Prevalence of LBW births among smoking FT users was 24% compared to 14% among nonsmoking FT users (P=0.03). Smokers using FT who delivered twins were six times more likely to have a LBW birth than nonsmokers (OR=6.1, P=0.003). After adjustment for maternal age, race/ethnicity, plurality, and smoking during pregnancy, smokers were three times more likely to have a LBW infant than nonsmokers (OR=2.92, P=0.003), and were four times more likely to deliver a very LBW (VLBW,<1500g) infant (OR=4.27, P=0.002). Prematurity rates did not differ between smoking and nonsmoking FT users. Conclusion: Prepregnancy smoking cessation interventions targeted at these highly educated, motivated mothers undergoing fertility treatments may have a large impact on reducing LBW and VLBW infants.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
1) Describe differences in birth outcomes between mothers who used fertility treatments and smoked before pregnancy compared to mothers using fertility treatments who did not smoke.

Keywords: Smoking, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an author on this abstract because I am the Maternal and Child Health Epidemiologist at the Maryland Department of Health and Mental Hygiene and responsible for the analysis and interpretation of perinatal health datasets.
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.