Prenatal Tobacco Cessation Reduces Risk: Small for Gestational Age Newborns

Objectives: Determine if prenatal tobacco cessation of patients at a women’s health clinic in a tertiary medical center in Appalachia reduces risk for SGA. Methods: Self-reported survey of tobacco use prior to and during pregnancy, birth certificate data, and clinic outpatient administrative records (n=982) from July 2006-December 2008 were aggregated. Multivariable logistic regression was used to estimate the relative odds of small for gestational age newborn by tobacco use status, controlling for maternal ethnicity and pregnancy induced hypertension. Results: The rate of prenatal smoking was 42.4% (n=416), with a cessation rate of 15.6% (n=153) while 26.8% (n=263) continued to smoke during pregnancy. The remaining 57.6% (n=566) were non-smokers. Rates of SGA were similar for the nonsmoking and smoking cessation groups at 9.0% and 8.5%, respectively. However, for women who continued smoking during pregnancy significantly more, 15.6% delivered SGA newborns (p=0.01). The relative odds of SGA were significantly elevated for women who smoked throughout pregnancy, OR=2.2 (95%CI 1.4-3.4;p =0.001). Pregnancy-induced hypertension and maternal ethnicity of African American/Other were independently significant, OR=3.5 (95%CI 1.1-11.4;p=0.39) and OR=2.2 (95%CI 1.3-3.6;p=0.002). Audience: Clinicians, staff for prenatal tobacco cessation programs. Key Points: In this outpatient prenatal care clinic in a tertiary medical center in Appalachia, women who quit smoking during pregnancy had a relative risk for SGA similar to nonsmokers. Educational Experience: These research findings can be referenced and used as a resource in provider/patient education. Benefits: This is an example of how birth outcome data can be used to evaluate a tobacco cessation program