Posttraumatic Symptom Reporting and Reported Cigarette Smoking During Pregnancy

Area of Science:

• Psychiatry
• Obstetrics & Gynecology
• Public Health

Background:

• Nicotine dependence is common in individuals with posttraumatic stress disorder (PTSD).
• Prenatal smoking poses significant risks to both mother and infant.
• Limited research exists on the link between trauma history, PTSD, and smoking during pregnancy.

Purpose of the Study:

• To investigate the prevalence of smoking during pregnancy in relation to prepregnancy trauma exposure and active PTSD symptoms.
• To identify predictors of continued cigarette smoking among pregnant women.

Main Methods:

• An anonymous survey was administered to pregnant women at an urban perinatal clinic.
• Participants completed measures of trauma history (Traumatic Life Events Questionnaire), PTSD symptoms (PTSD Symptom Checklist-Civilian Version), and smoking behavior.
• "Pregnant smokers" were defined as those smoking any cigarettes after pregnancy confirmation.

Main Results:

• 15.6% of 218 women reported smoking after pregnancy confirmation.
• Trauma exposure (resulting in fear, helplessness, or horror), current PTSD symptom severity, and probable PTSD diagnosis were significant unadjusted predictors of smoking during pregnancy.
• After adjusting for age, PTSD symptoms remained significantly associated with smoking during pregnancy; however, this association was not significant when prior heavy smoking history was considered.

Conclusions:

• Behavioral responses to past trauma influence smoking behavior before pregnancy.
• These behaviors increase the risk of continued tobacco use during pregnancy.
• A trauma-informed approach to smoking cessation in preconception care may reduce prenatal smoking and warrants further investigation.