Biochemically confirmed smoking cessation and gestational weight gain

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Addiction Medicine

Background:

• Prenatal smoking cessation offers significant health benefits for both mothers and newborns.
• Concerns regarding maternal weight gain can act as a barrier for pregnant individuals attempting to quit smoking.

Purpose of the Study:

• To quantify the association between biochemically confirmed smoking cessation during pregnancy and gestational weight gain.
• To compare weight gain patterns between women who quit smoking and those who continued smoking during pregnancy.

Main Methods:

• Utilized data from the randomized controlled "Smoking Cessation in Pregnancy" project (1987-1991).
• Calculated gestational weight gain using self-reported prepregnancy weight and measured weight at 30-34 weeks gestation.
• Employed linear regression to estimate adjusted mean differences in weight gain between quitters and continuing smokers, analyzing effects of early versus late cessation.

Main Results:

• Quitters gained more weight by 30-34 weeks: 3.0 lbs (nulliparous) and 6.6 lbs (multiparous) compared to continuing smokers.
• No significant difference in weight gain was observed between early (2nd trimester) and late (3rd trimester) quitters.
• Quitters were more likely to exceed Institute of Medicine (IOM) weight gain recommendations (60.3% vs 46.3%) and less likely to gain below recommendations (11.5% vs 21.6%).

Conclusions:

• While smoking cessation in pregnancy is associated with modest additional weight gain, a high proportion of both quitters and continuing smokers exceed IOM recommended gestational weight gain.
• Both groups, quitters and continuing smokers, may require interventions and support to achieve optimal gestational weight gain.
• Addressing concerns about weight gain is crucial to encourage smoking cessation during pregnancy.