American Journal of Epidemiology Vol. 154, No. 8 : 694-701
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Effects of Smoking Reduction during Pregnancy on the Birth Weight of Term Infants
1 Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Program Office, Centers for Disease Control and Prevention, Atlanta, GA.
2 Pregnancy and Infant Health Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
3 Statistics and Computer Resources Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
4 Program Services and Development Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
5 Childhood Vaccine Preventable Diseases Branch, Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA.
6 Training, Development, and Management Activity, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA.
This study was undertaken to determine 1) whether reducing tobacco exposure during pregnancy increases the birth weight of term infants and 2) the relative effects of early- and late-pregnancy exposure to tobacco on infant birth weight. Data were obtained from the Smoking Cessation in Pregnancy project, conducted in public clinics in three states (Colorado, Maryland, and Missouri) between 1987 and 1991. Self-reported cigarette use and urine cotinine concentration were collected from 1,583 pregnant smokers at study enrollment and in the third trimester. General linear models were used to generate mean adjusted birth weights for women who reduced their tobacco exposure by 50 percent or more and for those who did not change their exposure. Regression smoothing techniques were used to characterize the relation between birth weight and early exposure and birth weight and third-trimester exposure. Reducing cigarette use was associated with an increase in mean adjusted birth weight of only 32 g, which was not significant (p = 0.33). As third-trimester cigarette use increased, birth weight declined sharply but leveled off at more than eight cigarettes per day. Findings were similar when urine cotinine concentration was used. Women who smoke during pregnancy may need to reduce to low levels of exposure (less than eight cigarettes per day) to improve infant birth weight.
birth weight; cotinine; nicotine; pregnancy; smoking; tobacco
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