The effects of different smoking patterns in pregnancy on perinatal outcomes in the Southampton Women’s Survey
The effects of different smoking patterns in pregnancy on perinatal outcomes in the Southampton Women’s Survey
Maternal smoking during pregnancy has established associations with poor perinatal outcomes. Among continuing pregnant smokers, harm-reduction strategies have been suggested, including temporary cessation of smoking during pregnancy, also known as partial quitting. Support for this strategy, however, remains limited. Six hundred and ninety-seven women in the Southampton Women’s Survey who smoked at their last menstrual period were categorised into sustained quitters, partial quitters (quit in either the first or third trimester but not both) or sustained smokers (continued to smoke throughout pregnancy). In regression models, compared with infants born to sustained smokers, infants born to sustained quitters and partial quitters were heavier at birth by β = 0.64 standard deviations (SD) (WHO z-score) (95% CI: 0.47–0.80) and 0.48 SD (WHO z-score) (95% CI: 0.24–0.72) respectively, adjusted for confounders, with similar patterns seen for other anthropometric measures (head circumference and crown–heel length). Sustained quitters had longer gestations by β = 3.5 days (95% CI: 1.8–5.2) compared with sustained smokers, but no difference was seen for partial quitters. While sustained quitting remains the most desired outcome for pregnant smokers, partial quitting should be explored as a strategy to reduce some of the harmful effects of smoking on offspring in those who cannot achieve sustained quitting.
Anthropometry, Birthweight, Crown–heel length, Gestation, Head circumference, Partial quitting, Perinatal outcomes, Pregnancy, Smoking
7991
O'Donnell, Martin
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Baird, Janis
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Cooper, Cyrus
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Crozier, Sarah
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Godfrey, Keith
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Geary, Michael
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Inskip, Hazel
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Hayes, Catherine B.
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1 November 2020
O'Donnell, Martin
90e5aa17-f202-4bcc-ab34-cb68428710e9
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Geary, Michael
76355138-6e5f-43a1-b180-b33e93916df8
Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Hayes, Catherine B.
dbe12cb7-7c77-44e9-98e1-a3c1301c660c
O'Donnell, Martin, Baird, Janis, Cooper, Cyrus, Crozier, Sarah, Godfrey, Keith, Geary, Michael, Inskip, Hazel and Hayes, Catherine B.
(2020)
The effects of different smoking patterns in pregnancy on perinatal outcomes in the Southampton Women’s Survey.
International Journal of Environmental Research and Public Health, 17 (21), , [7991].
(doi:10.3390/ijerph17217991).
Abstract
Maternal smoking during pregnancy has established associations with poor perinatal outcomes. Among continuing pregnant smokers, harm-reduction strategies have been suggested, including temporary cessation of smoking during pregnancy, also known as partial quitting. Support for this strategy, however, remains limited. Six hundred and ninety-seven women in the Southampton Women’s Survey who smoked at their last menstrual period were categorised into sustained quitters, partial quitters (quit in either the first or third trimester but not both) or sustained smokers (continued to smoke throughout pregnancy). In regression models, compared with infants born to sustained smokers, infants born to sustained quitters and partial quitters were heavier at birth by β = 0.64 standard deviations (SD) (WHO z-score) (95% CI: 0.47–0.80) and 0.48 SD (WHO z-score) (95% CI: 0.24–0.72) respectively, adjusted for confounders, with similar patterns seen for other anthropometric measures (head circumference and crown–heel length). Sustained quitters had longer gestations by β = 3.5 days (95% CI: 1.8–5.2) compared with sustained smokers, but no difference was seen for partial quitters. While sustained quitting remains the most desired outcome for pregnant smokers, partial quitting should be explored as a strategy to reduce some of the harmful effects of smoking on offspring in those who cannot achieve sustained quitting.
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The Effects of Different Smoking Patterns
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Accepted/In Press date: 21 October 2020
e-pub ahead of print date: 30 October 2020
Published date: 1 November 2020
Additional Information:
Funding Information:
Funding: This work from the SWS was supported by grants from the Medical Research Council (MC_UU_12011/4), National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton National Health Service Foundation Trust, the European Union’s Seventh Framework Programme (FP7/2007-2013), project Early Nutrition (grant 289346) and European Union’s Horizon 2020 research and innovation programme under grant agreement No 733206, 9.6 M€ (LifeCycle). K.M.G. is supported by the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and the NIHR Southampton Biomedical Research Centre) and the European Union (Erasmus+ Programme Early Nutrition eAcademy Southeast Asia-573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP). Study participants were drawn from a cohort study funded by the Medical Research Council and the Dunhill Medical Trust. M.M.O. received funding to undertake the research leading to these results as part of the Irish Academic Track for Internship Initiative under the supervision and guidance of C.B.H. This funding was provided by the Health Service Executive (Ireland) National Doctors Training and Planning Unit and University College Dublin School of Medicine and Medical Science.
Funding Information:
Conflicts of Interest: K.M.G. has received reimbursement for speaking at conferences sponsored by companies selling nutritional products and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec, BenevolentAI Bio Ltd. and Danone. The other authors have nothing to disclose. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords:
Anthropometry, Birthweight, Crown–heel length, Gestation, Head circumference, Partial quitting, Perinatal outcomes, Pregnancy, Smoking
Identifiers
Local EPrints ID: 444938
URI: http://eprints.soton.ac.uk/id/eprint/444938
ISSN: 1660-4601
PURE UUID: 892591dd-7980-4b1a-a135-ace904862717
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Date deposited: 12 Nov 2020 17:32
Last modified: 18 Mar 2024 02:56
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Author:
Martin O'Donnell
Author:
Michael Geary
Author:
Catherine B. Hayes
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