Renee D Goodwin1, Keely Cheslack-Postava2, Deborah B Nelson3, Philip H Smith4, Melanie M Wall5, Deborah S Hasin6, Yoko Nomura7, Sandro Galea8. 1. Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA; Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. Electronic address: rdg66@columbia.edu. 2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. 3. Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA; Department of Obstetrics and Gynecology, Temple University School of Medicine, Philadelphia, PA, USA. 4. Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education/CUNY School of Medicine, New York, NY, USA. 5. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA. 6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. 7. Department of Psychology, Queens College and The Graduate Center, City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine, New York, NY, USA. 8. Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA.
Abstract
BACKGROUND: Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status. OBJECTIVES: The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005 to 2014. STUDY DESIGN: Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health. RESULTS: Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005 to 2014. CONCLUSIONS: Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed.
BACKGROUND: Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status. OBJECTIVES: The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005 to 2014. STUDY DESIGN: Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health. RESULTS: Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005 to 2014. CONCLUSIONS: Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed.
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