Fluctuations of maternal smoking during pregnancy
Fluctuations of maternal smoking during pregnancy
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DOI：
10.1016/s0029-7844(02)02370-0
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发表时间：
2003-01-01
影响因子：
7.2
通讯作者：
Leventhal, BL
中科院分区：
文献类型：
--
作者：
Pickett, KE;Wakschlag, LS;Leventhal, BL
目的：研究怀孕期间妇女吸烟的波动，对怀孕吸烟者的临床干预设计和胎儿接触香烟的影响研究的意义。方法：我们检查了1426名在1991年怀孕和吸烟补充全国健康访谈调查中报告在最后一次怀孕期间吸烟的妇女的绝对吸烟状况的变化，以及家庭健康和发展项目中60名怀孕吸烟者的吸烟量波动。结果：在1991年全国健康访谈调查妊娠和吸烟补充中，相当大比例的妇女表现出反复戒烟和复发的模式。在多变量logistic回归模型中，高中以上学历与间歇性吸烟者与连续吸烟者显著相关（优势比= 1.55,P < 0.01），与成功戒烟与持续吸烟或复吸（优势比= 1.74,P < 0.01）。在家庭健康和发展项目中，吸烟强度的波动也很大，尽管48%的人在得知怀孕后戒烟或减少吸烟，但超过一半的人多次改变吸烟强度。结论：我们得出结论，对许多妇女来说，怀孕期间吸烟是一种复杂而多变的行为。对吸烟的简单测量可能会导致对吸烟对胎儿的影响的低估，而在怀孕早期进行短暂的戒烟干预可能对怀孕期间的许多吸烟者来说是不够的。(C) 2003年由美国妇产科医师学会出版。
OBJECTIVE: To examine fluctuations in women's cigarette smoking during pregnancy and implications for the design of clinical interventions for pregnant smokers and research on the effects of fetal exposure to cigarettes.METHODS: We examined changes in absolute smoking status in 1426 women who reportedly smoked during their last pregnancy in the National Health Interview Survey 1991 Pregnancy and Smoking Supplement and fluctuations in amount smoked in 60 pregnant smokers in the Family Health and Development Project.RESULTS: In the National Health Interview Survey 1991 Pregnancy and Smoking Supplement, a substantial proportion of women exhibited a pattern of repeated cessation and relapse. In multivariable logistic regression models, having more than a high school education was significantly associated with being an intermittent versus a continuous smoker (odds ratio = 1.55, P < .01) and with successful quitting versus continuously smoking or relapsing (odds ratio = 1.74, P < .01). Fluctuations in smoking intensity in the Family Health and Development Project were also substantial and, although 48% quit or reduced their smoking upon learning of their pregnancy, over half changed smoking intensity multiple times.CONCLUSION: We conclude that smoking during pregnancy is a complex and variable behavior for many women. Simple measures of smoking may lead to under-estimation of the impact of smoking on the fetus, and brief smoking cessation interventions early in pregnancy are likely to be inadequate for many smokers during pregnancy. (C) 2003 by The American College of Obstetricians and Gynecologists.