The Effects of Maternal Tobacco Use on Low Birth Weight in Texas 2001
Abstract
Low birth weight (LBW) is a major contributor to infant mortality and
childhood morbidity and mortality. Maternal smoking is a major cause of low birth
weight. This population-based retrospective cohort study examined the effects of
maternal tobacco use during pregnancy on the incidence of LBW Computerized data
of Texas 2001 live birth certificates were used, and only singleton births were
analyzed. Descriptive statistics, relative risks, 95% confidence intervals, logistic
regression analyses, and a multiple linear regression analysis were used to examine
the association between maternal smoking and LBW. Mothers who smoked during pregnancy were twice as likely than non-smokers (95% Cl = 1.707 - 1.852) to have a
low birth weight infant both before and after adjustment of covanates (sex of child;
maternal age; maternal education; maternal racial/ethnicity; maternal tobacco use;
maternal alcohol use; prenatal care, maternal marital status; maternal medical risk
factors for this pregnancy, Medicaid status; preterm labor, preterm birth; and maternal
weight gain during pregnancy). Less educated women (for 7 to 11 years of education,
RR = 1.566, 95% Cl = 1.48 - 1.66); women with medical problems (for diabetes, RR
= 1.104, 95% Cl = 1.021 - 1.193; for chronic hypertension, RR = 3.121, 95% Cl =
2.866 - 3.399; and for pregnancy associated hypertension, RR = 2.936, 95% Cl =
2.818 - 3.058); women with inadequate weight gain during pregnancy (for less than
17 pounds, RR = 3.337, 95% Cl = 3.17 - 3.51); those who were on Medicaid (RR =
1 209, 95% Cl = 1.177 - 1.242); those who used alcohol during pregnancy (RR =
1.628, 95% Cl = 1.468 - 1 805); those who had no prenatal care (for those who had
prenatal care, RR = 0.432, 95% Cl = 0.402 - 0.464); women who had a preterm birth
(RR =12 114, 95% Cl = 11.802 - 12 434); and women who had preterm delivery (RR
= 9.816, 95% Cl = 9 572 - 10.066) were at a higher risk of giving birth to LBW
infants than mothers without these risk factors. Women who were 20 years old or
older were less likely to have a LBW birth Births who were male were also less
likely to be LBW than female births (RR = 0 89, 95% Cl = 0.868 - 0 914) Before adjustment for covariates, non-Hispanic whites had the lowest risk for LBW, and nonHispanic blacks had two times higher risk than non-Hispanic whites. However, after
adjustment for these covanates, Hispamcs had the lowest risk of LBW and nonHispanic whites had the highest risk The risk of LBW associated with maternal
smoking also differed among the three racial/ethnic groups: non-Hispanic white
smokers had the highest risk (OR = 2.033, 95% Cl = 1.874 - 2.205), non-Hispamc
black smokers had the second highest risk (OR = 1.780, 95% Cl = 1.518 - 2.088), and
Hispanic smokers had the lowest risk (OR = 1.721, 95% Cl = 1.470 - 2.016).
Educating women and teens about the risk of maternal tobacco use and other risk
factors for low birth weight is an important intervention for reducing the incidence of
LBW. Further studies should also be conducted to better understand potential factors
among Hispanic women that lead to a reduced risk for LBW compared to women
from other racial/ethnic groups.
Citation
Park, O. (2004). The effects of maternal tobacco use on low birth weight in Texas 2001 (Unpublished thesis). Texas State University-San Marcos, San Marcos, Texas.Download
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