Effects of smoking cessation with voucher-based contingency management on birth outcomes
Effects of smoking cessation with voucher-based contingency management on birth outcomes
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DOI：
10.1111/j.1360-0443.2010.03073.x
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发表时间：
2010-11-01
期刊：
影响因子：
6
通讯作者：
Solomon, Laura J.
中科院分区：
文献类型：
--
作者：
Higgins, Stephen T.;Bernstein, Ira M.;Solomon, Laura J.
目的本研究探讨是否戒烟使用凭证为基础的应急管理（CM）改善出生结果。设计数据来自三个对照试验。设置每个试验都在同一个研究诊所进行，专门研究吸烟和怀孕。参与者参与者（n = 166）是孕妇谁参加了试验检查凭证为基础的CM戒烟的有效性。妇女被分配到一个偶然的条件，其中他们赚取的代金券可兑换为零售项目的戒烟，或到一个非偶然的条件，他们收到的代金券独立于吸烟状态。通过回顾医院分娩记录确定出生结局。结果产前禁欲是更大的条件比非条件，与孕晚期禁欲分别为34.1%和7.4%（P < 0.001）。在偶然条件下治疗的母亲所生婴儿的平均出生体重大于在非偶然条件下治疗的母亲所生婴儿的平均出生体重（3295.6 +/- 63.8 g vs 3093.6 +/- 67.0 g，P = 0.03）和低出生体重的百分比（< 2500 g）的分娩率较低（5.9%对18.5%，P = 0.02）。在研究的其他三种结局中未观察到显著的治疗效果，尽管每种结局在偶然条件下与非偶然条件下都有改善的趋势：平均胎龄（39.1 +/- 0.2周vs 38.5 +/- 0.3周，P = 0.06），早产百分比（5.9对13.6，P = 0.09），和新生儿重症监护室的入院率（4.7%对13.8%，P = 0.06）。结论这些结果提供了证据，戒烟治疗券为基础的CM可能会改善重要的出生结局。
Aims This study examined whether smoking cessation using voucher-based contingency management (CM) improves birth outcomes. Design Data were combined from three controlled trials. Setting Each of the trials was conducted in the same research clinic devoted to smoking and pregnancy. Participants Participants (n = 166) were pregnant women who participated in trials examining the efficacy of voucher-based CM for smoking cessation. Women were assigned to either a contingent condition, wherein they earned vouchers exchangeable for retail items by abstaining from smoking, or to a non-contingent condition where they received vouchers independent of smoking status. Measurement Birth outcomes were determined by review of hospital delivery records. Findings Antepartum abstinence was greater in the contingent than non-contingent condition, with late-pregnancy abstinence being 34.1% versus 7.4% (P < 0.001). Mean birth weight of infants born to mothers treated in the contingent condition was greater than infants born to mothers treated in the non-contingent condition (3295.6 +/- 63.8 g versus 3093.6 +/- 67.0 g, P = 0.03) and the percentage of low birth weight (< 2500 g) deliveries was less (5.9% versus 18.5%, P = 0.02). No significant treatment effects were observed across three other outcomes investigated, although each was in the direction of improved outcomes in the contingent versus the non-contingent condition: mean gestational age (39.1 +/- 0.2 weeks versus 38.5 +/- 0.3 weeks, P = 0.06), percentage of preterm deliveries (5.9 versus 13.6, P = 0.09), and percentage of admissions to the neonatal intensive care unit (4.7% versus 13.8%, P = 0.06). Conclusions These results provide evidence that smoking-cessation treatment with voucher-based CM may improve important birth outcomes.