Stressful life events are associated with perinatal cigarette smoking

Alicia M Allen, Alesia M. Jung, Andrine M Lemieux, Adam C. Alexander, Sharon S Allen, Kenneth D. Ward, Mustafa N al'Absi

Research output: Contribution to journalArticle

Abstract

Perinatal smoking, including smoking during pregnancy and postpartum smoking relapse, is a persistent public health problem. While childhood trauma has been linked to perinatal smoking, less is known about the association with more proximal stressful life events (SLEs). The objective of this study was to examine the association between SLEs that occurred during the year prior to childbirth with perinatal smoking. Using the Pregnancy Risk Assessment Monitoring System 2009–2011, perinatal smoking was assessed at three time points: (1) three months prior to pregnancy, (2) the last three months of pregnancy, and (3) two to six months postpartum. Survey respondents endorsed up to 13 SLEs (i.e., death of someone close). SLEs were analyzed individually, as well as using a cumulative score (range 0–13). Weighted analyses included unadjusted and adjusted logistic regression. Among those who smoked prior to pregnancy (n = 15,316), 48% (n = 7308) reported quitting smoking during pregnancy. Of those, 44% (n = 3126) reported postpartum smoking relapse. A total of 11 SLEs were associated with smoking during pregnancy and 2 SLEs were associated with postpartum smoking relapse. The odds of continued smoking during pregnancy was 12% higher for each SLE endorsed (adjusted odds ratio [aOR] = 1.12, 95% confidence interval [CI]: 1.09, 1.15) and this association was attenuated in relation to the odds of postpartum smoking relapse (aOR = 1.03, 95% CI: 0.99, 1.08). SLEs are associated with perinatal smoking. Additional research is needed to elucidate the mechanisms of action and to develop interventions specific to the needs of women who experience SLEs.

Original languageEnglish (US)
Pages (from-to)264-271
Number of pages8
JournalPreventive Medicine
Volume118
DOIs
StatePublished - Jan 1 2019

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Smoking
Pregnancy
Postpartum Period
Recurrence
Odds Ratio
Confidence Intervals
Life Change Events
Public Health
Logistic Models
Parturition
Wounds and Injuries

Keywords

  • Cigarette smoking
  • PRAMS
  • Postpartum
  • Pregnancy
  • Stress

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

Cite this

Stressful life events are associated with perinatal cigarette smoking. / Allen, Alicia M; Jung, Alesia M.; Lemieux, Andrine M; Alexander, Adam C.; Allen, Sharon S; Ward, Kenneth D.; al'Absi, Mustafa N.

In: Preventive Medicine, Vol. 118, 01.01.2019, p. 264-271.

Research output: Contribution to journalArticle

Allen, Alicia M ; Jung, Alesia M. ; Lemieux, Andrine M ; Alexander, Adam C. ; Allen, Sharon S ; Ward, Kenneth D. ; al'Absi, Mustafa N. / Stressful life events are associated with perinatal cigarette smoking. In: Preventive Medicine. 2019 ; Vol. 118. pp. 264-271.
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abstract = "Perinatal smoking, including smoking during pregnancy and postpartum smoking relapse, is a persistent public health problem. While childhood trauma has been linked to perinatal smoking, less is known about the association with more proximal stressful life events (SLEs). The objective of this study was to examine the association between SLEs that occurred during the year prior to childbirth with perinatal smoking. Using the Pregnancy Risk Assessment Monitoring System 2009–2011, perinatal smoking was assessed at three time points: (1) three months prior to pregnancy, (2) the last three months of pregnancy, and (3) two to six months postpartum. Survey respondents endorsed up to 13 SLEs (i.e., death of someone close). SLEs were analyzed individually, as well as using a cumulative score (range 0–13). Weighted analyses included unadjusted and adjusted logistic regression. Among those who smoked prior to pregnancy (n = 15,316), 48{\%} (n = 7308) reported quitting smoking during pregnancy. Of those, 44{\%} (n = 3126) reported postpartum smoking relapse. A total of 11 SLEs were associated with smoking during pregnancy and 2 SLEs were associated with postpartum smoking relapse. The odds of continued smoking during pregnancy was 12{\%} higher for each SLE endorsed (adjusted odds ratio [aOR] = 1.12, 95{\%} confidence interval [CI]: 1.09, 1.15) and this association was attenuated in relation to the odds of postpartum smoking relapse (aOR = 1.03, 95{\%} CI: 0.99, 1.08). SLEs are associated with perinatal smoking. Additional research is needed to elucidate the mechanisms of action and to develop interventions specific to the needs of women who experience SLEs.",
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