Maternal tobacco smoking among pregnant Palestinian women: risk for women and newborns

Abstract

Aim: To investigate the prevalence and the patterns of maternal smoking during pregnancy and to address specific adverse pregnancy outcomes among women in the north of the West Bank, Palestine. Methods: In a cross sectional study, 2066 pregnant women from the north of the West Bank were recruited to complete a selfadministered questionnaire modified from the Pregnancy Risk Assessment Monitoring System. Results: Of the 1853 pregnant women who participated in this study, 8.1% were current smokers (7.2% waterpipe and 3.7% cigarettes), and 11.9% were former smokers (10.9% waterpipe and 2.8% cigarettes). Most of the current smokers (67.5%) and former smokers (78.5%) smoked daily. Pregnant smokers and former smokers were more likely than non-smokers to be exposed to second hand smoke at home, and were more likely to identify as refugees (p value <0.05). The logistic-regression model revealed that current smokers during pregnancy were more likely than nonsmokers to have increased gestational blood lipids and blood pressure, increased blood pressure before pregnancy, premature birth and low birth weight in the newborn (P value< 0.05). Former smokers were more likely than nonsmokers to have increased gestational blood lipids and at least one abortion case (P value <0.05). Conclusion: This study presents tobacco use during pregnancy as a particularly important public health problem. The high rate of maternal smoking during pregnancy and its adverse outcomes on both the mother and the child indicate the urgent need to develop continued and effective cessation strategies. Prevention programs should focus on refugee women, who are at highest risk of smoking.