Bad pregnancy outcome doesn't make smokers quit

NEW YORK (Reuters Health) - For women who smoked during their first pregnancy and had problems in that pregnancy, the experience has little effect on whether they smoke while pregnant again, a new study shows.

Dr. Sven Cnattingius of the Karolinska Institute in Stockholm, Sweden and colleagues looked at data on 98,778 women who had been pregnant twice and reported smoking cigarettes daily during their first pregnancy. The team classified stillbirth, sudden infant death syndrome (SIDS), premature birth and small-for-gestational-age infants as smoking-related outcomes, while infant death due to birth defects was not considered to be smoking-related.

Overall, the researchers found, 70 percent of the women smoked during their second pregnancy. Less educated and younger women, as well as those who smoked heavily, were more likely to continue to smoke in their second pregnancy.

Women who had a previous small-for-gestational-age baby were at an increased likelihood of smoking during their second pregnancy, the researchers report in the American Journal of Obstetrics & Gynecology, while those who had stillbirths or a child who died due to congenital malformations were less likely to smoke.

It is particularly important for women who have had a bad smoking-related pregnancy outcome to quit for subsequent pregnancies, as they are at higher risk of having such problems again, Cnattingius and colleagues note. The findings suggest, they add, that current public health efforts to help pregnant women quit are "insufficient."

"In addition to public health campaigns, more patient-centered strategies and assistance from the caregivers also need to be considered," they conclude.

SOURCE: American Journal of Obstetrics & Gynecology, December 2006.