Browsing by Author "Bondy, Susan J. (7103146360)"

Objectives Middle-and low-income countries rarely have national surveillance data on smoking in pregnancy. This nationwide population- representative survey investigated pre-and post-partum smoking and their predictors in Serbia. Methods Using stratified two-stage random cluster sampling, 2,721 women in 66 health care centres were interviewed at 3 and 6 months post-partum. Results 37.2% of women smoked at some point in pregnancy (average 8.8 cigarettes/per day). Smoking at pregnancy onset and during pregnancy was associated with smoking by others in the home and lower education and family socio-economic status. Almost a quarter of women (23.2%) who quit smoking during pregnancy did not relapse 6 months post-partum. Older women, primiparae, university students and white-collar workers were more likely to successfully quit smoking. More than a half of women were exposed to SHS in their homes (57.6%) and 84.6% allowed smoking in their homes. Conclusion Smoking during pregnancy in Serbia was two-to threefold higher than in the most affluent western countries. Target groups for action are women with lower education and socio-economic status, as well as health professionals and family members who smoke. © 2012 Swiss School of Public Health.

In a nationwide study of Serbian births, in 2008, we estimated the influence of maternal prenatal smoking and environmental tobacco smoke (ETS) exposure on birth outcomes. Using stratified two-stage random cluster sampling, 2,721 women were interviewed in-person (response rates 98.1 %), and 2,613 singleton live births were included. Date of birth, gender, birthweight, birth height and head circumference were copied from the official hospital Birth Certificate. Six exposure categories were defined according to mother's smoking history and exposure to ETS. We calculated adjusted mean values and group differences by analysis of covariance, and adjusted odds ratios for the low birthweight (LBW < 2,500 g). Compared to the reference category (non-smoking, non-exposed to ETS) we observed birthweight reductions in infants whose mothers smoked continuously during the pregnancy and were exposed to ETS (-162.6 g) and whose mothers were not exposed to ETS (-173 g) (p = 0.000, and p = 0.003, respectively), as well as reduction in birth length (-1.01 and -1.06 cm; p = 0.003 and p = 0.000, respectively). Reduction in birthweight and birth length related to exposure categories was not linear. Adjusted OR for LBW was almost tripled for mothers who smoked over the entire pregnancy and were non-exposed to ETS (aOR 2.85; 95 % CI 1.46-5.08), and who were exposed to ETS (aOR 2.68; 95 % CI 1.15-6.25). Our results showed strong effects of smoking throughout the pregnancy on reduced birthweight, birth length and head circumference, and increased risk for LBW. We were not able to detect an effect for ETS exposure alone. © 2012 Springer Science+Business Media New York.