Purpose: The objective of this study was to describe the current state of smoking and alcohol drinking among pregnant women, and assess the factors related to smoking behavior during pregnancy.

Methods: Subjects were mothers whose children had undergone 4-month checkups publicly provided by Kyoto City in February 2007. An anonymous self-administered questionnaire survey about their smoking and alcohol drinking behavior was conducted. Chi-square tests and a logistic regression analysis were carried out to assess the factors related to smoking behavior during pregnancy.

Results: Out of a total of 999, 722 questionnaires were returned (response rate, 72.3%). Usable questionnaires were 689 (available response rate, 69.0%). The prevalence levels of alcohol drinking during prenatal, pregnant and postnatal periods were 55.9%, 9.1%, 22.1%, respectively. In 586 breast feeding mothers, the prevalence of alcohol drinking was 19.5%. The percentages of women smoking during prenatal, pregnant and postnatal periods were 23.4%, 7.5%, 9.0%, respectively. Out of prenatal smokers, the rate of quit smoking taking advantage of pregnancy was 67.7%. The prevalence of their husbands' smoking was 43.1%. Logistic regression analysis showed that "young age (<25 years)", "drinking alcohol during pregnancy" and "passive smoking due to their husbands" were significantly related to smoking during pregnancy.

Conclusion: Maternal smoking and alcohol drinking are important public health problems. The prevalence of smoking during pregnancy was found to be especially high in young women, and some pregnant women could not quit smoking. Approximately half of pregnant women were exposed to passive smoking. The prevalence of alcohol drinking during pregnancy was high in women aged more than 40 years. It is necessary to give knowledge about obstetric and perinatal complications of smoking and alcohol drinking for childbearing-age women, and provide support help quit smoking and alcohol drinking giving due consideration to age.

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