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Erschienen in:

01.11.2010

Smoking Among Pregnant Women with Medicaid Insurance: Are Mental Health Factors Related?

verfasst von: Jodi Summers Holtrop, Cristian Meghea, Jennifer E. Raffo, Lynette Biery, Shelby Berkowitz Chartkoff, LeeAnne Roman

Erschienen in: Maternal and Child Health Journal | Ausgabe 6/2010

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Abstract

Smoking during pregnancy is the single most modifiable risk factor for poor birth outcomes, yet it remains prevalent among low-income women. This study examined factors associated with continued smoking and quitting among pregnant women. A total of 2,203 Medicaid-eligible pregnant women were screened at their first enhanced prenatal services visit for risk factors including demographics, health behaviors (smoking, alcohol and drug use), mental health (history of mental health disorders, current depressive symptoms), and stress. Smoking status was divided into non-smokers, quitters (quit smoking since learning of pregnancy), and continuing smokers. Descriptive statistics and logistic regression models were used to describe the sample and analyze relationships between smoking status and other characteristics. Overall, 57% were non-smokers, 17% quitters, and 26% continuing smokers. Approximately 18% had severe depressive symptoms, 53% had a high stress score, and 33% had a history of mental health problems. Younger women had lower odds of continued smoking as compared to both non-smokers (OR = 0.48, p < 0.01) and quitters (OR = 0.56, p < 0.05). Older women with less than a 12th grade education had higher odds of continued smoking (OR = 2.17, p < 0.01) and quitting (OR = 1.62, p < 0.05) as compared to non-smokers. Alcohol use (OR = 2.81, p < 0.05) and drug use before pregnancy (OR = 5.32, p < 0.01) predicted continued smoking compared to non-smoking. Women with a mental health history (OR = 1.81, p < 0.01) and high stress scores (OR = 1.39, p < 0.05) had higher odds of continued smoking compared to non-smokers. Mental health history, stress, demographics, current alcohol and past drug use are strongly related to continued smoking in this population.

Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States 2000. JAMA, 291(10), 1238–1245.CrossRefPubMed

US Department of Health and Human Services. (2001). Women and smoking: A report of the surgeon general. Report summary. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

Lannero, E., Wickman, M., Pershagen, G., & Nordvall, L. (2006). Maternal smoking during pregnancy increases the risk of recurrent wheezing during the first years of life (BAMSE). Respiratory Research, 7, 3.CrossRefPubMed

US Department of Health and Human Services. (2004). The health consequences of smoking: A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

Malik, S., Cleves, M. A., Honein, M. A., Romitti, P. A., Botto, L. D., Yang, S., et al. (2008). Maternal smoking and congenital heart defects. Pediatrics, 121(4), e810–e816.CrossRefPubMed

Colman, G. J., & Joyce, T. (2003). Trends in smoking before, during, and after pregnancy in ten states. American Journal of Preventive Medicine, 24(1), 29–35.CrossRefPubMed

Tong, V. T., Jones, J. R., Dietz, P. M., D’Angelo, D., & Bombard, J. M. (2009). Trends in smoking before, during, and after pregnancy—pregnancy risk assessment monitoring system (PRAMS), United States, 31 sites, 2000–2005. MMWR Surveillance Summaries, 58(4), 1–29.

Kahn, R. S., Certain, L., & Whitaker, R. C. (2002). A reexamination of smoking before, during, and after pregnancy. American Journal of Public Health, 92(11), 1801–1808.CrossRefPubMed

Orr, S. T., Blazer, D. G., James, S. A., & Reiter, J. P. (2007). Depressive symptoms and indicators of maternal health status during pregnancy. Journal of Womens Health (Larchmt), 16(4), 535–542.CrossRef

10.

Blalock, J. A., Robinson, J. D., Wetter, D. W., & Cinciripini, P. M. (2006). Relationship of DSM-IV-based depressive disorders to smoking cessation and smoking reduction in pregnant smokers. The American Journal on Addictions, 15(4), 268–277.CrossRefPubMed

11.

Orr, S. T., Newton, E., Tarwater, P. M., & Weismiller, D. (2005). Factors associated with prenatal smoking among black women in eastern North Carolina. Maternal and Child Health Journal, 9(3), 245–252.CrossRefPubMed

12.

Blalock, J. A., Fouladi, R. T., Wetter, D. W., & Cinciripini, P. M. (2005). Depression in pregnant women seeking smoking cessation treatment. Addictive Behaviors, 30(6), 1195–1208.CrossRefPubMed

13.

Marcus, S. M., Flynn, H. A., Blow, F. C., & Barry, K. L. (2003). Depressive symptoms among pregnant women screened in obstetrics settings. Journal of Womens Health (Larchmt), 12(4), 373–380.CrossRef

14.

Zhu, S. H., & Valbo, A. (2002). Depression and smoking during pregnancy. Addictive Behaviors, 27(4), 649–658.CrossRefPubMed

15.

Ludman, E. J., McBride, C. M., Nelson, J. C., Curry, S. J., Grothaus, L. C., Lando, H. A., et al. (2000). Stress, depressive symptoms, and smoking cessation among pregnant women. Health Psychology, 19(1), 21–27.CrossRefPubMed

16.

Goodwin, R. D., Keyes, K., & Simuro, N. (2007). Mental disorders and nicotine dependence among pregnant women in the United States. Obstetrics and Gynecology, 109(4), 875–883.PubMed

17.

Flick, L. H., Cook, C. A., Homan, S. M., McSweeney, M., Campbell, C., & Parnell, L. (2006). Persistent tobacco use during pregnancy and the likelihood of psychiatric disorders. American Journal of Public Health, 96(10), 1799–1807.CrossRefPubMed

18.

Kavanaugh, M., McMillen, R. C., Pascoe, J. M., Hill Southward, L., Winickoff, J. P., & Weitzman, M. (2005). The co-occurrence of maternal depressive symptoms and smoking in a national survey of mothers. Ambulatory Pediatrics, 5(6), 341–348.CrossRefPubMed

19.

Roman, L. A., Meghea, C. I., Raffo, J. E., Biery, H. L., Chartkoff, S. B., & Zhu, Q., et al. (2008). Who participates in state sponsored medicaid enhanced prenatal services? Maternal and Child Health Journal.

20.

Mullen, P. D., Carbonari, J. P., Tabak, E. R., & Glenday, M. C. (1991). Improving disclosure of smoking by pregnant women. American Journal of Obstetrics and Gynecology, 165(2), 409–413.PubMed

21.

Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The fagerstrom test for nicotine dependence: A revision of the fagerstrom tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127.CrossRefPubMed

22.

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. Applications to addictive behaviors. The American Psychologist, 47(9), 1102–1114.CrossRefPubMed

23.

DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59(2), 295–304.CrossRefPubMed

24.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRefPubMed

25.

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292.CrossRefPubMed

26.

Murray, D. C. J. (1990). Screening for depression during pregnancy with the edinburgh postnatal depression scale (EPDS). Journal of Reproductive and Infant Psychology, 8, 63–65.CrossRef

27.

Harrison, P. A., & Sidebottom, A. C. (2008). Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Maternal and Child Health Journal.

28.

Burns, L., Mattick, R. P., & Wallace, C. (2008). Smoking patterns and outcomes in a population of pregnant women with other substance use disorders. Nicotine and Tobacco Research, 10(6), 969–974.CrossRefPubMed

29.

Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychology Measurement, (1), 385–401.

30.

McCormick, M. C., Brooks-Gunn, J., Shorter, T., Holmes, J. H., Wallace, C. Y., & Heagarty, M. C. (1990). Factors associated with smoking in low-income pregnant women: Relationship to birth weight, stressful life events, social support, health behaviors and mental distress. Journal of Clinical Epidemiology, 43(5), 441–448.CrossRefPubMed

31.

Higgins, S. T., Heil, S. H., Badger, G. J., Mongeon, J. A., Solomon, L. J., McHale, L., et al. (2007). Biochemical verification of smoking status in pregnant and recently postpartum women. Experimental and Clinical Psychopharmacology, 15(1), 58–66.CrossRefPubMed

32.

Klebanoff, M. A., Levine, R. J., Morris, C. D., Hauth, J. C., Sibai, B. M., Ben Curet, L., et al. (2001). Accuracy of self-reported cigarette smoking among pregnant women in the 1990s. Paediatric and Perinatal Epidemiology, 15(2), 140–143.CrossRefPubMed

33.

Clinical Practice Guideline Treating Tobacco Use and Dependence. (2008). Update panel. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A US Public Health Service report. American Journal of Preventive Medicine, 35(2), 158–76.

Titel: Smoking Among Pregnant Women with Medicaid Insurance: Are Mental Health Factors Related?
verfasst von: Jodi Summers Holtrop
Cristian Meghea
Jennifer E. Raffo
Lynette Biery
Shelby Berkowitz Chartkoff
LeeAnne Roman
Publikationsdatum: 01.11.2010
Verlag: Springer US
Erschienen in: Maternal and Child Health Journal / Ausgabe 6/2010
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-009-0530-x

Springer Medizin

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