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Updated: Tue, 3 Nov 2009 10:00:10 MST
Important Facts for Smoking in the Third Trimester of PregnancyDefinitionThis indicator provides information on women who reported smoking during the third trimester of their pregnancies.NumeratorNumber of women reported on Utah Certificates of Live Births as having smoked in the last trimester of their pregnancies.DenominatorNumber of live births to Utah residents regardless of where they occurred.Data Interpretation IssuesCigarette data is obtained through self-report by women through either responses to survey questions within four months of a live birth (PRAMS data) or through Certificates of Live Births (Utah Vital Records data). Either of these processes may result in recall bias. The percent of women who report smoking in the third trimester of pregnancy is higher on the PRAMS surveys (5.1%) which are submitted anonymously than on certificates of live births (3.9%) on which the mothers' names are included. Due to the stigma attached to smoking during pregnancy, women may be less than forthcoming regarding their use of tobacco resulting in under-reporting of actual cigarette usage.Why Is This Important?2008 Utah Vital Records data drawn from certificates of live births indicate that 3.9% of women smoked during the last trimester of their pregnancies. According to the 2004 Surgeon General's Report, The Health Consequences of Smoking, cigarette smoking during pregnancy increases the risk for: preterm, premature rupture of membranes; abruption placentae; placenta previa; preterm delivery; stillbirth; neonatal mortality; low birth weight; fetal growth restriction/small for gestational age; and Sudden Infant Death Syndrome (SIDS). Additionally, women who smoke are less likely to initiate and continue breastfeeding their infants. Evidence also suggests, but cannot prove, a causal relationship between smoking and ectopic pregnancy and spontaneous abortion.Some unfavorable pregnancy outcomes may be reduced or eliminated through smoking cessation, especially if cessation occurs early in pregnancy. This is true for birth weight which decreases as the number of cigarettes smoked increases. Smoking cessation by the third trimester of pregnancy can eliminate much of the fetal weight reduction risk incurred through maternal smoking. Maternal smoking may also lead to low birth weight (LBW) through complications requiring premature delivery such as preterm, premature rupture of membranges, abruptio placentae, or placenta previa. It has been estimated that the occurrence of LBW could be reduced by as much as 20% and fetal growth restriction by 30% if all women were nonsmokers during pregnancy. Other ObjectivesThere is no Healthy People 2010 Objective for third trimester smoking. However, there is a more general 2010 Objective to increase by 30% the women ages 18-49 who stop smoking in the first trimester of pregnancy.How Are We Doing?According to Utah Vital Records, during 2008, 3.9% or 2,166 Utah women experiencing a live birth reported smoking during the third trimester of pregnancy. This figure represents a slight decrease from 4.1% in 2007. From 1999 through 2008, the highest percentage of third trimester smoking occurred in 2001 with 7.7% of women experiencing a live birth reporting smoking in the third trimester of pregnancy. The lowest percentage of third trimester smoking occurred in 2003, and again in 2008, with 3.9% of women reporting smoking in the third trimester of pregnancy.How Do We Compare With U.S.?There are currently no published national data on smoking in the third trimester of pregnancy.What Is Being Done?The American College of Obstetricians and Gynecologists recommends that pregnant smokers be assessed for smoking activity and readiness to quit and provided resources to assist in cessation at each prenatal visit.In Utah, all local health departments screen pregnant clients for smoking and provide resources and referrals to promote cessation. The Utah Department of Health's Medicaid Program and Department of Workforce Services workers screen all pregnant applicants for tobacco use at the time of enrollment. Smokers are provided cessation information and followed-up every six weeks throughout their pregnancies. Medicaid enrollees are eligible for five individual cessation counseling sessions of 40 minutes each available through the Utah Department of Health's Tobacco Prevention and Control Program's Utah Tobacco Quit Line (1-888-567-TRUTH). Pregnant women are also eligible to receive tobacco cessation counseling through contracted agencies. Medicaid clients and Primary Care Network enrollees are eligible for the Zyban Program (Bupropion SR) with a prescription from their physicians. Additionally, pregnant Medicaid enrollees are eligible for all types of nicotine replacement therapies. Additional information, resources, and helpful website links can be found online at the March of Dimes website (www.modimes.org) by clicking on "pregnancy" and searching the topic "smoking." |