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Interventions for promoting smoking cessation during pregnancy.
J Lumley1, S S Oliver, C Chamberlain
1Centre for the Study of Mothers' and Children's Health, La Trobe University, 251 Faraday Street, Carlton, Vic, Australia, 3053.
Smoking cessation programs during pregnancy effectively reduce the number of women who smoke, leading to lower rates of low birthweight and preterm birth. These interventions improve fetal and infant health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Neonatology
Background:
- Smoking during pregnancy is a significant preventable risk factor for adverse perinatal outcomes, including low birthweight, preterm birth, and perinatal mortality.
- Identifying effective interventions to support smoking cessation in pregnant individuals is crucial for improving maternal and infant health.
Purpose of the Study:
- To systematically evaluate the impact of smoking cessation programs implemented during pregnancy on various maternal and infant health indicators.
- To synthesize evidence from randomized and quasi-randomized controlled trials to determine the efficacy of these interventions.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Cochrane Pregnancy and Childbirth Group, Cochrane Tobacco Addiction Group, MEDLINE, EMBASE, PsychLIT, CINAHL, AUSTHEALTH) up to July 2003.
- Included were 64 trials, comprising 51 randomized controlled trials (RCTs) and 6 cluster-RCTs, involving over 28,000 women.
- Trial quality was assessed, and data were extracted independently by four reviewers.
Main Results:
- Smoking cessation interventions significantly reduced the proportion of women who continued to smoke (RR 0.94, 95% CI 0.93 to 0.95).
- These programs were associated with a reduction in low birthweight (RR 0.81, 95% CI 0.70 to 0.94) and preterm birth (RR 0.84, 95% CI 0.72 to 0.98), and an increase in mean birthweight (+33 g).
- No statistically significant differences were found for very low birthweight, stillbirths, or perinatal/neonatal mortality due to limited statistical power.
Conclusions:
- Smoking cessation programs implemented during pregnancy are effective in reducing smoking rates among pregnant individuals.
- These interventions positively impact key perinatal outcomes, specifically lowering the incidence of low birthweight and preterm birth.
- Further research with larger sample sizes is needed to definitively assess the impact on perinatal mortality and very low birthweight.
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