The European Journal of Public Health Advance Access originally published online on November 22, 2005
The European Journal of Public Health 2006 16(2):168-172; doi:10.1093/eurpub/cki219
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Maternal and Child Health |
Adolescent smoking in pregnancy and birth outcomes
Ali Delpisheh1, Eman Attia1, Sandra Drammond2 and Bernard J. Brabin1,3,4
1 Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
2 Liverpool Women's Hospital, Liverpool, UK
3 Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, The Netherlands
4 Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK
Correspondence: Professor B.J. Brabin, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK, tel: +44 151 705 3207, fax: +44 151 709 3329, e-mail: B.J.Brabin{at}liv.ac.uk
Introduction: Cigarette smoking amongst pregnant adolescents is a preventable risk factor associated with low birthweight (<2500 g), preterm birth (<37 weeks) and infant mortality. The aim of this study was to compare birth outcomes of adolescents who smoke during pregnancy with those who do not and to construct their birthweight-for-gestational-age curves. Methods: A retrospective cohort analysis of 534 adolescents (
19 years) and 8972 adults who delivered singleton births between 1998–2003 at the Liverpool Women's Hospital. Results: Adolescent pregnancy occurred in 5.6% of deliveries. Mean age of adolescents was 18.1 years (SD = 1.0) and 46.2% smoked during pregnancy including 83.5% light smokers (<10 cigarettes daily). Babies born to adolescent smokers were significantly lighter by –170 g (P = 0.005). The prevalence of low birthweight was almost double in adolescents who smoked (12.1% versus 6.8%, RR = 1.7; CI = 1.0–3.0), and their mean Apgar scores at 5 min were lower (<0.05). A higher prevalence of preterm birth (P < 0.05) and maternal anaemia (P < 0.01) occurred amongst adolescent smokers. Adolescents smoking >10 cigarettes daily had babies with larger birthweight reduction (P = 0.001). Conclusion: Almost half of all adolescents smoked during their pregnancy. Birthweight-for-gestational-age curves of smoking adolescents showed a marked fall-off in weight from 36 weeks of gestation, and at least 10% of adolescent smokers showed fetal growth restriction from before 32 weeks of gestation.
Keywords: adolescent, birth outcome, pregnancy, smoking
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