Association between Secondhand Smoke Exposure in the Home during Pregnancy and Low Birth Weight
Keywords:
second hand smoke, pregnant women, low birth weight, Secondhand smoke exposure in the homeAbstract
Several studies have shown that maternal exposure to secondhand smoke (SHS) during pregnancy is associated with detrimental effects on the mother and the fetus, including impaired fetal growth, low birth weight, and preterm delivery. However, most studies have been conducted in foreign countries. Studies of SHS exposure in the home during pregnancy are limited in Thailand. The present study investigated SHS in the home during pregnancy alongside other factors and their associations with low birth weight.
This prospective cohort study was carried out in seven government hospitals, Phetchabun province, Thailand. A total of 1,264 pregnant women who came to receive antenatal care at these hospitals between June and December 2018 were included in this study, after excluding those who reported active smoking during their current pregnancy. Participants were selected by using two-stage cluster random sampling. Data were collected using interviews, including maternal characteristics, pregnancy history, and SHS exposure. The researchers reviewed extracted information about infant birth weight from medical records. The primary outcome in this study was low birth weight (<2,500 grams). Descriptive statistics were analyzed using percentage, mean, standard deviation, minimum and maximum. Univariate analysis and multivariate analysis were performed using binary logistic regression to investigate the effect of SHS exposure in the home during pregnancy alongside other factors on low birth weight. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were estimated. All analyses were conducted using R statistical language (v3.2.4) and a binary logistic regression model was performed using the R library. A significance level of 0.05 was used throughout all analyses.
The results showed that 5.9% of infants had low birth weight. After adjusting for maternal body mass index, gestational weight gain and infant’s gestational age at birth, we found that a high level of SHS exposure in the home during pregnancy was strongly associated with low birth weight (AOR= 3.42; 95% CI = 1.57–7.45). In terms of other covariates, a pre-pregnancy body mass index of 23.0-27.4 kg/m2 (AOR= 0.34; 95% CI = 0.15–0.75), adequate gestational weight gain (AOR= 0.45; 95% CI = 0.27–0.88), excessive gestational weight gain (AOR= 0.44; 95% CI = 0.23–0.87), and gestational age at birth ≥37 weeks (AOR= 0.11; 95% CI = 0.06–0.21; p<0.001) were also strongly associated with low birth weight.
This study demonstrates that SHS exposure in the home during pregnancy is associated with low birth weight. Other factors such as BMI before pregnancy, gestational weight gain and gestational age at birth could also be associated with low birth weight. Therefore, healthcare personnel should provide education programs to improve pregnant women’s and their husbands’ understanding and awareness of the harmful effects of SHS exposure on infant birth weight. Other smokers should decrease pregnant women’s exposure to SHS, by changing smoking places, quitting smoking, and not smoking in the home.
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