Maternal tobacco exposure and health-related quality of life during pregnancy: a national-based study of pregnant women in China

Abstract

Background With the increase of the number of smokers, tobacco exposure among pregnant women is becoming more and more common. Pregnant women exposed to first-hand smoke and second-hand smoke are susceptible to physiological and psychological health issues has been proved in previous studies. Nevertheless, there are no enough studies focus on the impact of third-hand smoke during pregnancy. This study aimed to assess and compare health-related quality of life for pregnant women with exposure to first-hand smoke, second-hand smoke, third-hand smoke and non-exposure to tobacco in mainland China. Methods National-based cross-sectional study is based on a questionnaire survey which collects information including demographics, smoking behaviors and self-evaluation. All questionnaires were delivered and collected from August to September 2019. EuroQol group’s visual analog scale and EuroQoL Five-dimension Questionnaire were used to collect data in mainland China. Results Totally, 15,682 pregnant women were included in this study, among which non-exposure to smoke were 7564 (48.2%), exposed to first-hand smoke, second-hand smoke and third-hand smoke were 89 (0.6%), 2349 (15.0%), and 5680 (36.2%) respectively. Pregnant women without tobacco exposure had the highest EuroQol group’s visual analog scale score (mean value = 85.4[SD = 14.0]), while those with first-hand smoke had the lowest score (mean value = 77.4[SD = 22.2]). Among all five dimensions of EuroQoL Five-dimension Questionnaire, there were significant differences of EQ-index among groups with different tobacco exposure in usual activity and anxiety or depression dimensions (p < 0.001). Conclusions Third-hand smoke exposure had close relationship with low health-related quality of life in pregnant women. Moreover, second-hand smoke exposure significantly led more problems on mental dimension of pregnant women.

Prenatal Exposure to PM2.5 and Its Specific Components and Risk of Hypertensive Disorders in Pregnancy: A Nationwide Cohort Study in China

“…Third, several potential risk factors for HDP, including a family history of hypertension, maternal smoking habit, physical activity, and status of maternal nutrition during pregnancy, were not collected in our study. While for maternal smoking habit, previous studies reported a very low prevalence (0.6%–3.8%) among pregnant women in China, and about 82.9% of smoking women quit smoking after they were pregnant. , Therefore, the confounding effect of maternal smoking habit might be toward null. Last, limited by exposure assessment techniques, only six major components of PM 2.5 were investigated in relation to the risk of HDP, and many other toxicity components (i.e., heavy metals) were not studied.…”

Association between secondhand smoke exposure in pregnant women and their socioeconomic status and its interaction with age: a cross-sectional study

“…China has the highest tobacco production and the most tobacco consumers in the world, and approximately 47.2% of Chinese males had smoking habits in an investigation conducted in 2013 [2]. Thus, with an increasing number of smokers, many nonsmoking people, especially pregnant women, children and elderly individuals, are more likely to suffer from passive tobacco exposure (so-called secondhand smoke (SHS)) [3,4]. Over the past few decades, many epidemiological studies have also suggested that the exposure of pregnant women to SHS by their partners was very common during pregnancy, even though they were nonsmokers [4][5][6].…”

“…Additionally, some investigations indicated that the self-reported rate of SHS exposure was relatively high in the third trimester [8][9][10]. Previous studies have shown that exposure to SHS is more serious than active smoking [3,11,12] because it is 3 to 4 times more damaging per gram of particulate matter than smoke directly inhaled by a smoker [13]. An increasing number of studies have indicated that exposure to SHS affects almost every type of adverse pregnancy outcome, such as depression disorders, low levels of health-related quality of life, preterm labor, rupture of membranes, and fetal weight loss [3,14,15].…”

“…Previous studies have shown that exposure to SHS is more serious than active smoking [3,11,12] because it is 3 to 4 times more damaging per gram of particulate matter than smoke directly inhaled by a smoker [13]. An increasing number of studies have indicated that exposure to SHS affects almost every type of adverse pregnancy outcome, such as depression disorders, low levels of health-related quality of life, preterm labor, rupture of membranes, and fetal weight loss [3,14,15]. Moreover, SHS includes at least 70 carcinogenic substances, increasing the risks of sudden infant death syndrome, cancers, and chronic kidney and respiratory diseases in children [16].…”

Physical Activity and Self-Perception of Mental and Physical Quality of Life during Pregnancy: A Systematic Review and Meta-Analysis

“…QoL not only depends on the time course of pregnancy but can be detrimentally affected by factors such as nausea, sleep difficulties, environment factors (i.e., tobacco exposure/intake) [7], financial challenges, lumbopelvic pain [8], or domestic violence [6]. Additionally, changes in body mass index, weight gain (specifically, excessive gains), or other complications can negatively influence one's self-perception of health status [9].…”