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The European Journal of Public Health Advance Access published online on November 22, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki219
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received January 28, 2005
Accepted October 6, 2005

Article

Adolescent smoking in pregnancy and birth outcomes

Ali Delpisheh 1, Eman Attia 1, Sandra Drammond 2, and Bernard J. Brabin 3 *

1 Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
2 Liverpool Women's Hospital, Liverpool, UK
3 Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK; Emma Kinderziekenhuis, Academic Medical Centre, University of Amsterdam, The Netherlands; Royal Liverpool Children's Hospital NHS Trust, Alder Hey, Liverpool, UK

* To whom correspondence should be addressed.
Bernard J. Brabin, E-mail: B.J.Brabin{at}liv.ac.uk


  Abstract

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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