Monitoring use of tobacco products among pregnant women is a public health priority, yet few studies in U.S. national samples have been reported on this topic. We examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of pregnant women. Data were obtained from all pregnant women (≥ 18 years) in the first wave of the Population Assessment of Tobacco and Health (PATH, 2013–2014) Study (N = 388). Prevalence of current and prior use of tobacco/nicotine products was examined overall and among current cigarette smokers. Multiple logistic regression was used to examine correlates of use of cigarettes, e-cigarettes, hookah and cigars. Overall prevalence was highest for cigarettes (13.8%), followed by e-cigarettes (4.9%), hookah (2.5%) and cigars (2.3%), and below 1% for all other products. Prevalence of using other tobacco products is much higher among current smokers than the general population, with e-cigarettes (28.5%) most prevalent followed by cigars (14.0%), hookah (12.4%), smokeless (4.7%), snus (4.6%), and pipes (2.1%). Sociodemographic characteristics (poverty, low educational attainment, White race) and past-year externalizing psychiatric symptoms were correlated with current cigarette smoking. In turn, current cigarette smoking and past year illicit drug use were correlated with using e-cigarettes, hookah, and cigars. These results underscore that tobacco/nicotine use during pregnancy extends beyond cigarettes. The results also suggest that use of these other products should be included in routine clinical screening on tobacco use, and the need for more intensive tobacco control and regulatory strategies targeting pregnant women.

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Objective To determine if there are differences in maternal and fetal characteristics in pregnancies complicated by preterm versus term preeclampsia. Methods Using our electronic database we identified 143 women who met the ACOG criteria for preeclampsia between January 1995 and August 2003. We collected data on age, weight, height, smoking status, maternal serum biochemical markers and newborn data. We compared the group delivering preterm (<37 weeks) with those delivering at term (≥37 weeks). Analyses were based on ANOVA, Wilcoxon Rank Sum tests and chi-square tests. Statistical significance was determined based on alpha = .05. Data are expressed as mean ± s.d. unless otherwise indicated. Results Eighty women delivered preterm and 63 delivered at term. Women who delivered preterm with preeclampsia were younger (age 24.4 ± 4.9 years vs 27.7 ± 6.0 yrs, P<0.001), lighter (BMI 25.8 ± 5.6 vs 28.9 ± 7.3 kg/m2, P=0.01) and were more likely to smoke cigarettes (28% vs 9%, P=0.008) than those delivering at term with preeclampsia. Maternal serum liver enzyme concentrations were significantly greater in the preterm group (peak AST 38 vs 30 U/L, P=0.006), (peak ALT 31 vs 23 U/L, P=0.001). Newborn birth weight percentile (gestational age specific) was significantly lower for preterm preeclampsia (25th ±29 vs 47th ±32 percentile, P<0.001). We found no significant differences in maternal platelet count nadir, peak uric acid concentration, or newborn gender between groups. Conclusions Differences exist in maternal and fetal characteristics between women who develop preterm preeclampsia and those who develop preeclampsia at term. These data support the hypothesis that multiple preeclamptic phenotypes exist.

IntroductionUnderstanding patterns of single and multiple tobacco product use among reproductive-aged women is critical given the potential for adverse health effects on mother and infant should a woman become pregnant.MethodsPatterns of tobacco use over a 2-year period were examined among all women (18–44 years) who completed wave 1 (W1) and wave 2 (W2) of the US Population Assessment of Tobacco and Health (PATH, 2013–2014, 2014–2015) Study. We examined the most common patterns of single and multiple tobacco product use in W1, and longitudinal trajectories of women engaged in each of these patterns of use from W1 to W2, among women not pregnant in either wave (n = 7480), not pregnant in W1 and pregnant in W2 (n = 332), and pregnant in W1 and not pregnant in W2 (n = 325).ResultsThe most prevalent patterns of tobacco use in W1 among all three subgroups were using cigarettes alone followed by using cigarettes plus e-cigarettes. In all three subgroups, women using multiple products in W1 were more likely to adopt new use patterns in W2 relative to single-product users, with the new patterns generally involving dropping rather than adding products. The majority of multiple product use included cigarettes, and transitions to single product use typically involved dropping the noncigarette product. The most common trajectory among tobacco users transitioning to or from pregnancy was to use cigarettes alone in W2.DiscussionThis study contributes new knowledge characterizing tobacco use patterns across time and reproductive events among reproductive-aged women.

This study examined quit rates longitudinally for cigarettes, e-cigarettes, hookah, cigars, and all tobacco products in a U.S. national sample of women aged 18-44 who completed both Wave 1 (W1) and Wave 2 (W2) of the Population Assessment of Tobacco and Health (PATH, 2013-2014, 2014-2015) study (N = 7814). Quit rates were examined among women who transitioned into pregnancy across survey waves, and among a comparable sample of non-pregnant women to provide contextual information about quitting among the broader population of reproductive-aged women. Multiple logistic regression modeling was used to estimate the associations of pregnancy and quitting adjusting for other demographic and psychosocial characteristics. Quit rates among women who were pregnant in W2 were highest for hookah (98.3%), followed by cigars (88.0%), e-cigarettes (81.3%), and lowest for tobacco cigarettes (53.4%). Slightly more than half (58.7%) of women reported quitting use all tobacco products while pregnant. Pregnancy was independently associated with increased odds of quitting hookah (AOR = 52.9, 95%CI = 3.4, 830.2), e-cigarettes (AOR = 21.0, 95%CI = 2.6, 170.3), all tobacco products (AOR = 9.6, 95%CI = 6.4, 14.5), and cigarettes (AOR = 6.5, 95%CI = 4.2, 10.1), although not cigars. Relative to other demographic and psychosocial characteristics, pregnancy was the strongest predictor of quitting use of each tobacco product. While these data indicate that pregnancy has strong, independent associations with quitting a variety of commercially available tobacco products, the comparatively lower quit rates for cigarettes versus other tobacco products underscores the long-standing need for more intensive, multipronged clinical and regulatory interventions to reduce cigarette use among reproductive-aged women.