Changes in smoking and drinking behaviour before and during pregnancy in Italian mothers: implications for public health intervention. ICGDUP (Italian Collaborative Group on Drug Use in Pregnancy).

Cigarette and alcohol use before and during pregnancy were studied in 4966 Italian women who delivered single liveborn infants. Using a standardized questionnaire mothers were interviewed in the early postpartum period about pregnancy-related events. Data are part of the Drug Use in Pregnancy (DUP) Study, an international epidemiological co-operative survey conducted under the auspices of the World Health Organization, in 22 countries during 1989-1990. Italian pregnant smokers were women under 30 years of age with a middle-school education or less, and drinkers were 30 years of age and more with more than a middle-school education. When pregnancy was confirmed, most of them cut down smoking and drinking but more so for smoking than drinking: 12% stopped smoking and 6% stopped drinking. Less than 1% gave up both. The more the mother smoked during pregnancy the lower was the infant's birthweight and the association between reduced fetal growth and higher smoking level persisted after controlling for confounding variables. Only smoking habits were associated with delivery of small-for-gestational age babies. A large proportion of Italian women use alcohol and cigarettes before and during pregnancy. Smoking during pregnancy is an important preventable risk factor for the delivery of a small-for-gestational-age child. Thus it may be worth campaigning more vigorously to encourage women to give up smoking during pregnancy.