Risky substance exposure during pregnancy: a pilot study from Lebanese mothers

Abstract

BackgroundThe harmful effects of medication and licit substance use during pregnancy may potentially constitute a major public health concern. Our study aims to assess risky exposure of Lebanese pregnant women to drugs, tobacco, caffeine, and alcohol, and to determine their effect on postnatal outcomes.MethodsWomen at term were addressed after delivery in five university hospitals of Beirut and Mount Lebanon between February and June 2012. A standardized questionnaire was administered to them. Moreover, medical files of both mothers and their respective newborns were checked to confirm information given by mothers, and to assess the health outcome of the babies.ResultsAmong the interviewed 350 women, active and passive smoking of tobacco (cigarette or water pipe), and consumption of category C, D, and X drugs were common during pregnancy in Lebanon; they were shown to negatively affect the neonatal outcome in multivariate analyses: they significantly decreased Apgar scores and increased the risk of underweight and medical complications of babies (P < 0.05).ConclusionOur study demonstrated that Lebanese women were exposed during pregnancy to multiple medications and licit substances that affected the neonates’ health. Our findings have implications for clinical obstetric practice and prevention programs in Lebanon. Efforts should be made to decrease exposure to harmful substances during pregnancy.

The effects of water-pipe smoking on birth weight: a population-based prospective cohort study in southern Iran

“…Although it has spread throughout the world, water-pipe smoking is still most pronounced in the eastern Mediterranean region [ 19 ]. We found that 8.2% of pregnant women in our study in southern Iran smoked water-pipe, which is quite similar to the results of studies conducted in Lebanon and Jordan (4-9%) [ 20 , 21 ]. In accordance with previous studies [ 21 , 22 ], most water-pipe smokers in our sample had low SES, more irregular prenatal visits, and more exposure to water-pipe smoke.…”

Health effects associated with waterpipe smoking

“…Other adverse pregnancy outcomes were also assessed in the aforementioned and other studies. The intensity of non-exclusive WPS was inversely correlated with the APGAR scores among newborns at 5 and 10 min in a retrospective study that did not adjust for cigarette smoking, 115 A strong association with the risk of perinatal pulmonary complications (OR=3.65, 95% CI 1.52 to 8.75) was also demonstrated among children born to exclusive WPS mothers. 116 A higher risk of infant mortality among Southern Asian WP smokers was also reported in a cross-sectional study, but the association did not reach statistical significance after adjustment for confounders.…”

“…WPS has been associated with obstetric and perinatal complications including low birthweight (LBW). 110–117 infant mortality, 118 low APGAR scores, 115 and pulmonary complications at birth. 116 Studies were primarily retrospective or cross-sectional and were conducted in Lebanon, 110 114–116 Qatar, 111 Iran, 112 113 the Gaza Strip 117 and Cambodia.…”

“…112 In contrast, a retrospective study, which controlled for substance intake, found a non-significant association with LBW (OR=1.8, 95% CI 0.67 to 5.38). 116 Other studies that supported an association between LBW and WPS did not account for concomitant cigarette smoking, 111 114 115 …”

“…Passive WPS was also associated with LBW independent of cigarette and wood fuel smoke in a case–control study; however, the study had low numbers of passive WP smokers and may have suffered from recall bias. 117 While a meta-analysis of three of the aforementioned studies 110 112 116 reported an overall 2.12 times odds of LBW in association with WPS, 7 these and several additional studies 111 114 115 that support an association between WPS and LBW are methodologically limited with incomplete adjustment for confounders. Larger prospective cohort studies that control for important confounders are still needed.…”