Smoking During Pregnancy

Smoking during pregnancy can have a negative impact on the health of infants and children by increasing the risk of complications during pregnancy, premature delivery, and low birth weight—a leading cause of infant mortality.1 Maternal cigarette use data is captured on birth certificates; however, data collection methods vary due to revisions to the birth certificate in 2003. As of 2005, the 1989 Standard Certificate of Live Birth (unrevised) was used in 36 States, New York City and Washington, DC, while 11 States used the revised birth certificate.2

In 2005, 10.7 percent of all pregnant women giving birth in areas using the unrevised birth certificate smoked cigarettes during their pregnancy. This varied by maternal race and ethnicity.

Among women in the unrevised reporting areas, American Indian/Alaska Native mothers were most likely to have smoked during pregnancy (18.1 percent), followed by non-Hispanic White women (13.9 percent). Smoking during pregnancy was higher among pregnant women in areas using the revised birth certificate (12.4 percent). Smoking was also most common among American Indian/Alaska Native mothers in these areas (24.6 percent). Asian/Pacific Islanders and Hispanic women were least likely to have smoked during pregnancy in both reporting areas.

Cigarette use also varied by maternal age in 2005. Among women in the unrevised reporting areas, women under 20 years of age were most likely to have smoked cigarettes during pregnancy (15.1 percent), followed by 13.0 percent of women aged 20–29 years. Similarly, 16.4 percent of women under 20 years of age in the revised reporting areas smoked during pregnancy, followed by 15.0 percent of women aged 20–29. Smoking during the postpartum period has negative consequences for the mother and infant. In 2004, 17.9 percent of mothers smoked postpartum (data not shown). Women at highest risk were young mothers (under 20 years), White mothers, and mothers whose pregnancy was unintended.3

1 U.S. Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. 2004.
2 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, Munson ML. Births: Final data for 2005. National vital statistics reports; vol 56 no 6. Hyattsville, MD: National Center for Health Statistics. 2007; Data for three states were not comparable to either the unrevised or revised birth certificate data.
3 Centers for Disease Control and Prevention. Preconception and Interconception Health Status of Women Who Recently Gave Birth to a Live-Born Infant – Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 Reporting Areas, 2004. Surveillance Summaries, Dec 14, 2007. MMWR 2007; 56 (No SS-10).

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