The Impact of Prior Poor Birth Outcomes on Smoking Behavior on Subsequent Pregnancies: Analysis of the National PRAMS Data.

Objectives: The link between cigarette smoking and poor birth outcomes has been well established. However, there is paucity of research investigating the effect of previous history of poor birth outcomes on smoking behavior during subsequent pregnancies. The present study seeks to determine whether a previous preterm or low birth weight delivery impacts maternal smoking during the subsequent pregnancy.

Methods: Data from the National Pregnancy Risk Assessment Monitoring System (PRAMS) was analyzed. Multiparous women who currently had singleton birth were included in the analysis (N = 137,297). Previous poor birth outcome and smoking were defined based on the PRAMS question that asked women whether their immediate previous baby was born preterm or low birth weight and if they smoked during the index pregnancy.

Results: Approximately 16.3 % of the women who reported previous poor birth outcome also reported smoking during the subsequent pregnancy. Multiple logistic regression analysis revealed that women who had previous poor birth outcome had 22 % higher odds of smoking during the subsequent pregnancy. Similarly, the odds of smoking during pregnancy were 30 and 13 % higher among women who had previous low birth weight and preterm birth, respectively.

Conclusions: Women who experienced previous preterm or low birth weight baby had higher prevalence of smoking during the subsequent pregnancy. The occurrence of a preterm/low birth weight may present a critical intervention point for providers to educate women on the risks of repeated poor birth outcomes and provide intervention programs to address high-risk behaviors.