Correlates of smoking in pregnant women in six Brazilian cities

Abstract

OBJECTIVE: To evaluate sociodemographic and lifestyle correlates of smoking in pregnant women sampled from hospitals. METHODS: A cross-sectional study was conducted in 5,539 pregnant women aged 20 or more who sought medical attention in prenatal clinics of affiliate hospitals of the Brazilian National Health System in the cities of Manaus, Fortaleza, Salvador, Rio de Janeiro, São Paulo, and Porto Alegre from 1991 to 1995. Interviews were conducted using a standardized questionnaire that covered sociodemographics and smoking habits before and during pregnancy. Current smoking was defined as smoking at least one cigarette/day, former smoking as reporting having smoked at least one cigarette/day but having quit, and never smoking as never having smoked one cigarette/day.. RESULTS: Smoking during pregnancy was associated with lower education (OR=2.13; CI 95%: 1.76-2.57) and greater parity (OR=1.84; CI 95%: 1.53-2.21). Positive associations were also found with increased gestational age and alcohol consumption. No significant association was found with skin color or occupation status. A protective effect was observed for women married or living with a partner (OR=0.55 CI 95%: 0.42-0.72). Having Manaus' women as a reference, Porto Alegre's women showed the greatest risk for smoking in pregnancy (OR=5.00; CI 95%: 3.35-7.38), followed by São Paulo's (OR=3.42; CI 95%: 2.25-5.20), Rio de Janeiro (OR=2.53; CI 95%: 1.65-3.88) and Fortaleza's (OR=2.56; CI 95%: 1.74-3.78). CONCLUSIONS: The study findings are similar to those described in the literature regarding education, parity, and marital status. However, no association with skin color was seen in the multivariate analysis. Former smokers had sociodemographic characteristics more similar to non-smokers than former smokers.