Pregnant Smokers: Great Expectations Dashed
TUESDAY, Aug. 28 (HealthScoutNews) -- One-third fewer pregnant women smoked in 1999 than at the beginning of the decade, the government reported today.
But if most women are getting the message, teen-age mothers-to-be continue to be stubborn, the Centers for Disease Control and Prevention (news - web sites) (CDC) said in its report.
After a dramatic 20 percent decline from 1990 to 1994, smoking rates among pregnant teen-agers between 15 and 19 years old shot back up 5 percent. These teens account for one in seven of the almost half million women who smoked while pregnant in 1999.
"That's just over 12 percent of women who had a live birth who smoked during pregnancy," says demographer T. J. Mathews at the CDC's National Center for Health Statistics in Hyattsville, Md. "We get this information from all the birth certificate information culled in the United States. Mothers answer questions on prenatal care, and one of the questions we ask is about smoking habits during pregnancy."
"The largest drop in smoking was in [pregnant] women ages 25 to 34," Mathews says. "They had a 40 percent drop in smoking. But while the decline in smoking continued in [pregnant] teen-agers up until 1994, it then started going back up again. It still is much lower than it was in 1990 -- about 15 percent lower -- but the decline clearly stalled." He couldn't give any reasons for the shift.
Women who smoke during pregnancy give birth to more premature babies, are at risk for numerous pregnancy complications, and have a higher rate of low-birthweight infants, stillbirths and infant mortality, the CDC says. Smoking also puts their babies at risk for sudden infant death syndrome (SIDS), poor lung development, asthma and respiratory infections.
The largest specific group of pregnant smokers is young white teen-agers, Mathews says. Thirty percent of these teens smoked during pregnancy, he says.
"You have dramatically low rates of smoking for Asian and Pacific Islanders," Mathews describes. "Overall, only 3 percent of them smoked, and still the largest group [among] those were teen-agers. The lowest amongst all the groups is Chinese mothers, who almost didn't smoke at all."
The report, Smoking During Pregnancy in the 1990s, shows that:
Of all ethnic groups, Native American women have the highest rate of smoking during pregnancy, at 20 percent.
Smoking rates among Hispanic and non-Hispanic black women during pregnancy were slashed by about 45 percent during the 1990s.
Puerto Rican mothers were much more likely to smoke than any other Hispanic group.
Education matters. Smoking during pregnancy ranged from 2 percent of the mothers who had at least four years of college to 29 percent for those who did not complete high school.
"These are high-risk pregnancies to begin with in teen-agers," says Dr. Alfred Munzer, past president of the American Lung Association and director of pulmonary medicine at Washington Adventist Hospital in Tacoma Park, Md. "The risk of still birth is doubled, infant mortality is doubled, and that's just one of the messages that people need to be aware of regarding smoking during pregnancy."
Munzer says the trend in teen-age smoking is very disturbing. "They are one part of the general population that's still being targeted by the tobacco industry. Smoking is still seen as cool among that population, and that's extremely unfortunate."
The effects of smoking on pregnancy last a long time, Munzer says. "There's increasing evidence that the growth of these infants is retarded by a mother's smoking, and as far as we can tell, that growth retardation persists into the teen years of the child. In fact, smoking during pregnancy affects the entire physical and mental development of the child."
Munzer says while the trend in smoking in the United States is encouraging, "it still remains an enormous health problem. The American Lung Association would like to see the Bush Administration take a stronger stand against smoking."