Tobacco use among pregnant women in Hungary: The unique role of an unplanned pregnancy

Background: Smoking during pregnancy is a risk factor for low birth weight (LBW) and preterm birth (PTB). High percentages of LBW (8.6%) and PTB (8.7%) in Hungary suggest a significant contribution of smoking to these outcomes. The goal of this research was to determine whether planned versus unplanned pregnancy contributed to smoking or cessation during pregnancy. . Methods: In a 2009-10 retrospective cohort study about smoking and cessation among 8,350 women, 42% smoked prior to pregnancy. Logistic regression was used to estimate whether a planned versus unplanned correlated to continued smoking during the pregnancy, controlling for other known risk factors. Results: 63.8% of pregnant women continued smoking after learning they were pregnant. If the pregnancy was unexpected, only 1 in 5 quit smoking. In logistic regression analysis, an expected pregnancy reduced the likelihood of continued smoking by 43 percent (OR=0.57, 95%CI=0.43-0.76), controlling for women's education, marital status, ethnicity, prior quit attempts, knowledge about the harms of tobacco, and exposure to secondhand smoke, having a smoking partner. Conclusion: Planned pregnancy have important implications for quitting. Identifying women whose pregnancy was not planned may indicate the need for tailored interventions that address the desirability of the pregnancy.