Longitudinal cohort survey of women's smoking behaviour and attitudes in pregnancy: study methods and baseline data

Orton, Sophie; Bowker, Katharine; Cooper, Sue; Naughton, Felix; Ussher, Michael; Pickett, Kate E.; Leonardi‐Bee, Jo; Sutton, Stephen; Dhalwani, Nafeesa N.; Coleman, Tim

doi:10.1136/bmjopen-2014-004915

Cited by 24 publications

(43 citation statements)

References 26 publications

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“…This study presents secondary analysis on data collected as part of the longitudinal cohort, the Pregnancy Lifestyle Survey (PLS); methods and cohort characteristics have been described in detail previously. 23 The study received a favourable opinion from Derbyshire Research Ethics Proportionate Review Sub-Committee (reference 11/EM/0078).…”

Section: Methodsmentioning

confidence: 99%

“…The baseline sample size for the PLS was 850, based on the cohort's primary aim to estimate the proportion of smokers who initiate quit attempts in the second or third trimester of pregnancy. 23 Women who were aged ≥16 years, between 8 and 26 weeks pregnant, and self-reported being current smokers or having smoked in the 3 months prior to pregnancy were eligible for participation.…”

Section: Methodsmentioning

confidence: 99%

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Smoking in the home after childbirth: prevalence and determinants in an English cohort

et al. 2015

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ObjectivesChildren's exposure to secondhand smoke (SHS) is causally linked to childhood morbidity and mortality. Over 38% of English children (aged 4–15) whose parents are smokers are exposed to SHS in the home. Little is known about the prevalence of SHS exposure in the homes of young infants (≤3 months). This study aimed to estimate maternal self-reported prevalence of SHS exposure among infants of women who smoked just before or during pregnancy, and identify factors associated with exposure.SettingPrimary Care, Nottingham, England.ParticipantsCurrent and recent ex-smoking pregnant women (n=850) were recruited in Nottingham, England. Women completed questionnaires at 8–26 weeks gestation and 3 months after childbirth. Data on smoking in the home 3 months after childbirth was available for 471 households.Primary and secondary outcome measuresMaternal-reported smoking in the home 3 months after childbirth.ResultsThe prevalence of smoking in the home 3 months after childbirth was 16.3% (95% CI 13.2% to 19.8%) and after multiple imputation controlling for non-response 18.2% (95% CI 14.0% to 22.5%). 59% of mothers were current smokers; of these, 24% reported that smoking occurred in their home compared to 4.7% of non-smokers. In multivariable logistic regression, mothers smoking ≥11 cigarettes per day were 8.2 times (95% CI 3.4 to 19.6) more likely to report smoking in the home. Younger age, being of non-white ethnicity, increased deprivation and less negative attitudes towards SHS were also associated with smoking in the home.ConclusionsThis survey of smoking in the home 3 months after childbirth found a lower prevalence than has been reported in older children. Interventions to support smoking mothers to quit, or to help them restrict smoking in the home, should target attitudinal change and address inequality relating to social disadvantage, younger age and non-white ethnic groups.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Smoking in the home after childbirth: prevalence and determinants in an English cohort

et al. 2015

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“…Cigarette smoke contains many teratogens, and exposure during pregnancy increases the risk of adverse pregnancy and neonatal outcomes, including placental abruption, placenta previa, sudden infant death syndrome, spontaneous abortion, stillbirth, low birth weight, and fetal growth restriction [ 5 – 11 ]. Although many pregnant women want to quit smoking, recent studies suggest that only 50% successfully abstain from smoking during pregnancy due in part to the highly addictive nature of nicotine [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal Nicotine Exposure Leads to Impaired Disulfide Bond Formation and Augmented Endoplasmic Reticulum Stress in the Rat Placenta

et al. 2015

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Maternal nicotine exposure has been associated with many adverse fetal and placental outcomes. Although underlying mechanisms remain elusive, recent studies have identified that augmented endoplasmic reticulum (ER) stress is linked to placental insufficiency. Moreover, ER function depends on proper disulfide bond formation—a partially oxygen-dependent process mediated by protein disulfide isomerase (PDI) and ER oxidoreductases. Given that nicotine compromised placental development in the rat, and placental insufficiency has been associated with poor disulfide bond formation and ER stress, we hypothesized that maternal nicotine exposure leads to both placental ER stress and impaired disulfide bond formation. To test this hypothesis, female Wistar rats received daily subcutaneous injections of either saline (vehicle) or nicotine bitartrate (1 mg/kg) for 14 days prior to mating and during pregnancy. Placentas were harvested on embryonic day 15 for analysis. Protein and mRNA expression of markers involved in ER stress (e.g., phosphorylated eIF2α, Grp78, Atf4, and CHOP), disulfide bond formation (e.g., PDI, QSOX1, VKORC1), hypoxia (Hif1α), and amino acid deprivation (GCN2) were quantified via Western blot and/or Real-time PCR. Maternal nicotine exposure led to increased expression of Grp78, phosphorylated eIF2α, Atf4, and CHOP (p<0.05) in the rat placenta, demonstrating the presence of augmented ER stress. Decreased expression of PDI and QSOX1 (p<0.05) reveal an impaired disulfide bond formation pathway, which may underlie nicotine-induced ER stress. Finally, elevated expression of Hif1α and GCN2 (p<0.05) indicate hypoxia and amino acid deprivation in nicotine-exposed placentas, respectively, which may also cause impaired disulfide bond formation and augmented ER stress. This study is the first to link maternal nicotine exposure with both placental ER stress and disulfide bond impairment in vivo, providing novel insight into the mechanisms underlying nicotine exposure during pregnancy on placental health.

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“…Smoking during pregnancy has been associated with several socio-demographic risk factors, such as a young age and low educational level (Balwicki et al 2016;Krstev et al 2012;Orton et al 2014), low economic level (Balwicki et al 2016;Krstev et al 2012;Maxson et al 2012), unemployment (Balwicki et al 2016;Orton et al 2014;Smedberg et al 2014), unexpected pregnancy (Suzuki et al 2010), and having a smoking partner (Orr et al 2012). On the other hand, women intending to breastfeed were found to be less likely to smoke during pregnancy (Haslam et al 2003).…”

Section: Introductionmentioning

confidence: 99%

Continued tobacco consumption during pregnancy and women’s depression and anxiety symptoms

Varela

Pereira

Pinto

et al. 2019

Int J Public Health

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Objectives This study aimed to analyse depression and anxiety symptoms changes from the first to the third trimester of pregnancy in non-smokers versus quitters versus continuous smokers, and the contribution of depression and anxiety symptoms to continued tobacco consumption during pregnancy. Methods The sample comprises 850 Spanish pregnant women (595 non-smokers, 123 quitters, and 132 continuous smokers), assessed at the first and the third trimester of pregnancy with a questionnaire concerning socio-demographic, obstetric, and tobacco consumption information, and measures of depression and anxiety. Results Continuous smokers during pregnancy showed more depression and anxiety symptoms than both non-smokers and quitters and no changes from the first trimester to the third trimester of pregnancy, while both non-smokers and quitters revealed a decrease in depression and anxiety symptoms. More anxiety symptoms at the first trimester (OR 1.03) and depression symptoms at the third trimester (OR 1.14) were associated with continued smoking during pregnancy. Conclusions Anxiety and depression symptoms need to be considered to screening for women at risk of smoking during pregnancy. Future prenatal smoking cessation interventions must take into account these variables.

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Longitudinal cohort survey of women's smoking behaviour and attitudes in pregnancy: study methods and baseline data

Cited by 24 publications

References 26 publications

Smoking in the home after childbirth: prevalence and determinants in an English cohort

Smoking in the home after childbirth: prevalence and determinants in an English cohort

Maternal Nicotine Exposure Leads to Impaired Disulfide Bond Formation and Augmented Endoplasmic Reticulum Stress in the Rat Placenta

Continued tobacco consumption during pregnancy and women’s depression and anxiety symptoms

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