Since 1987 the CDC has been surveying pregnant women in 40 states and New York City for health-related activities and outcomes. The Pregnancy Risk Assessment Monitoring System (PRAM) recently reported on the frequency of smoking by women before, during and after pregnancy. Some of the results were good, but some were not so hot.
Smoking during pregnancy is known to have deleterious effects on the fetus and newborns. It can cause fetal growth retardation and preterm delivery, and can also contribute to infant deaths. For example, according to PRAM statistics, in 2002, 5% 8% of preterm deliveries, 13% 19% of term infants with growth restriction, 5% 7% of preterm-related deaths, and 23% 34% of deaths from sudden infant death syndrome were attributed to prenatal smoking in the United States.
The recent report covered the period between 2000 and 2010, and aggregated data from 40 sites. It was based on self-reported data on smoking, and on birth certificates. Sadly, for the majority of the surveyed sites, smoking prevalence before, during or after pregnancy didn t change over the survey period.
There was some good news, however. In Minnesota, New York state and Utah smoking prevalence did decrease before, during, and after pregnancy. And in eight sites it decreased in one or two of the measures. Unfortunately, in Louisiana, Mississippi, and West Virginia smoking increased for all three of the measures.
For a subgroup of 10 sites with data for the entire survey period, while smoking prevalence didn t change with respect to the pre-pregnancy period, it did decrease significantly during pregnancy from 13.3 percent in 2000 to 12.3 percent in 2010.
ACSH s Dr. Elizabeth Whelan s opinion: Obviously the success of anti-smoking advisories has been spotty. It s very disturbing that at a time when it s widely understood how harmful smoking during pregnancy can be, some women are clearly not getting the message. These data should inform public health authorities as to where to target stronger messages, whether by mass media campaigns, encouraging smoke-free policies or reaching out to physicians to emphasize the importance of advising women about pregnancy-related smoking risks. Of course, helping women to quit smoking with more effective cessation methods would also be a big plus.
