Do socioeconomic factors explain why maternal smoking during pregnancy is more frequent in a more developed city of Brazil?

Abstract

The prevalence of smoking during pregnancy in Ribeirão Preto, a rich Brazilian city, was significantly higher (21.4%) than in São Luís (5.9%), a less developed city. To assess which variables explain the difference in prevalence of smoking during pregnancy, data from two birth cohorts were used, including 2846 puerperae from Ribeirão Preto, in 1994, and 2443 puerperae from São Luís, in 1997/98. In multivariable analysis, risk of maternal smoking during pregnancy was higher in São Luís for mothers living in a household with five or more persons (OR = 1.72, 95%CI = 1.12-2.64), aged 35 years or older (OR = 1.98, 95%CI = 0.99-3.96), who had five or more children (OR = 2.10, 95%CI = 1.16-3.81), and whose companion smoked (OR = 2.20, 95%CI = 1.52-3.18). Age of less than 20 years was a protective factor (OR = 0.55, 95%CI = 0.33-0.92). In Ribeirão Preto there was association with maternal low educational level (OR = 2.18, 95%CI = 1.30-3.65) and with a smoking companion (OR = 3.25, 95%CI = 2.52-4.18). Receiving prenatal care was a protective factor (OR = 0.24, 95%CI = 0.11-0.49). Mothers from Ribeirão Preto who worked outside the home were at a higher risk and those aged 35 years or older or who attended five or more prenatal care visits were at lower risk of smoking during pregnancy as compared to mothers from São Luís. Smoking by the companion reduced the difference between smoking rates in the two cities by 10%. The socioeconomic variables in the model did not explain the higher prevalence of smoking during pregnancy in the more developed city.

Ethnic differences in tobacco use during pregnancy: findings from a primary care sample in São Paulo, Brazil

“…Information on sociodemographic characteristics included partner status (i.e., cohabitating with a partner, yes=1, no=0), age (categories 16–19, 20–29, 30–44), educational level (greater than 9 years=1, less than 9 years=0), and income (categories in USD $0–350, $351–705, $706 or greater). The sociodemographic characteristics are critical covariates given that prior studies have reported that partner status (Ribeiro, 2007) and education (Malta, 2010) are significant correlates of smoking among the Brazilian population.…”

“…A recent national survey estimated approximately 13% of Brazilian women were tobacco users (Giovino, Mirza, Samet, Gupta, Jarvis, Bhala, et al, 2012). Despite the growing recognition of the correlates of smoking during pregnancy (Ribeiro et al, 2007; Kroeff et al, 2004; Jansen et al, 2010), our understanding of ethnic differences in and factors associated with antenatal tobacco use in LAMICs such as Brazil is limited. To date, there are very few documented ethnic disparities in smoking related risk for birth outcomes in Brazil.…”

Prevalência e fatores associados ao hábito de fumar de gestantes na cidade de São Luís, Maranhão, Brasil

“…5 Na cidade de São Luís (MA), estudo anterior que avaliou o consumo de tabaco na população gestante encontrou prevalência de 5,9%. 6 Alguns fatores comumente associados ao tabagismo durante gravidez são a baixa escolaridade, idade avançada, maior paridade e consumo de álcool. [6][7][8][9][10] Por outro lado, o maior número de consultas pré-natais, maior renda familiar e possuir companheiro são exemplos de fatores de proteção.…”

“…6 Alguns fatores comumente associados ao tabagismo durante gravidez são a baixa escolaridade, idade avançada, maior paridade e consumo de álcool. [6][7][8][9][10] Por outro lado, o maior número de consultas pré-natais, maior renda familiar e possuir companheiro são exemplos de fatores de proteção. [6][7][8] Outras variáveis, como possuir religião e trabalhar fora de casa, são fatores que também podem influenciar os hábitos de vida, tendo seus efeitos sido investigados em alguns estudos sobre o consumo de tabaco.…”

Associação entre consumo de tabaco e álcool na gestação e desenvolvimento infantil na coorte do pré natal de Ribeirão Preto/SP, 2010/13

“…Alguns estudos brasileiros apontam associação entre tabagismo materno na gravidez e baixa renda, e relatam que há queda na taxa do hábito de fumar até 22º semana de gravidez na população com renda maior (RIBEIRO et al, 2007). (ALIYU et al, 2009).…”