Behavioral impact of poor birth outcomes on subsequent pregnancies: A study of Virginia PRAMS 2007-2010

Background: Considering that 1 of every 8 infants in the U.S. is born preterm, much research has focused on the modifiable causes of the problem. Both cigarette smoking and alcohol use during pregnancy have been associated with preterm birth. The present study seeks to determine whether a previous preterm or low birthweight delivery impacts maternal smoking and drinking during the subsequent pregnancy. Methods: The 2007-2010 Virginia Pregnancy Risk Assessment Monitoring System (PRAMS) and linked birth certificate data was used for the present analysis. Women who reported smoking and/or drinking were categorized as having engaged in risky behavior. Women were asked whether their previous baby was born preterm or low birthweight; a “yes” to either resulted in categorization of previous poor birth outcome. Results: The final sample included 1101 women who reported a previous live birth; 16.4% (n=262) of which resulted in a poor birth outcome; 21% of the sample reported risk behavior during the subsequent pregnancy. Logistic regression analysis revealed no statistically significant differences in risk behavior between women who had experienced a poor birth outcome in their previous pregnancy and those who had not. Conclusion: Prior history of preterm birth has no impact on women's smoking behaviors on subsequent pregnancy. The occurrence of a preterm birth presents a critical intervention point for medical providers to educate women on the risks of repeated preterm and high-risk behaviors during a subsequent pregnancy.