Document Detail

Levels of excess infant deaths attributable to maternal smoking during pregnancy in the United States.
MedLine Citation:
PMID:  14682499     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The objectives of the study were: 1) To determine the risk of infant mortality associated with prenatal cigarette smoking; 2) To assess whether the relationship, if existent, was dose-dependent; 3) To explore the morbidity pathway that explains the effect of tobacco smoke on infant mortality, and 4) to compute excess infant deaths attributable to maternal smoking in the United States. METHODS: Retrospective cohort study on 3,004,616 singleton live births that occurred in 1997 in the United States using the US national linked birth/infant death data. Excess infant deaths due to maternal smoking were computed using the population-attributable risk (PAR). RESULTS: Overall, 13.2% of pregnant women who delivered live births in 1997 smoked during pregnancy. The rate of infant mortality was 40% higher in this group as compared to nonsmoking gravidas (P < 0.0001). This risk increased with the amount of cigarettes consumed prenatally in a dose-dependent fashion (p for trend < 0.0001). Small-for-gestational age rather than preterm birth is the main mechanism through which smoking causes excess infant mortality. We estimated that about 5% of infant deaths in the United States were attributable to maternal smoking while pregnant, with variations by race/ethnicity. The proportion of infant deaths attributable to maternal smoking was highest among American Indians at 13%, almost three times the national average. If pregnant smokers were to halt tobacco use a total of 986 infant deaths would be averted annually. CONCLUSIONS: Smoking during pregnancy accounts for a sizeable number of infant deaths in the United States. This highlights the need for infusion of more resources into existing smoking cessation campaigns in order to achieve higher quit rates, and substantially diminish current levels of smoking-associated infant deaths.
Hamisu M Salihu; Muktar H Aliyu; Bosny J Pierre-Louis; Greg R Alexander
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Maternal and child health journal     Volume:  7     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-19     Completed Date:  2004-04-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-27     Citation Subset:  IM    
Department of Maternal and Child Health, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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MeSH Terms
Chi-Square Distribution
Infant Mortality*
Infant, Newborn
Logistic Models
Pregnancy Complications / epidemiology,  prevention & control
Retrospective Studies
Risk Assessment
Smoking / adverse effects*,  epidemiology
Statistics, Nonparametric
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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