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Smoking prevalence trends: An analysis of smoking at pregnancy registration and at discharge from a midwife Lead Maternity Carer, 2008 to 2010

Abstract:

Background: Smoking during pregnancy has a detrimental effect on both maternal and neonatal health. The government has agreed a long term goal for New Zealand (NZ) to become a smoke-free nation by 2025, with smoking cessation during pregnancy a government priority. Contemporary information, reviewing the prevalence and demographics of women who smoke during pregnancy, is important so that change can be monitored and cessation support appropriately targeted. Aim: To examine the prevalence of smoking for 81,821 pregnant women who registered with a midwife Lead Maternity Carer (LMC) between the years 2008 to 2010. Methods: A retrospective observational design using aggregated clinical data from the New Zealand College of Midwives clinical outcomes research database (COMCORD) for the years 2008 to 2010. Women’s self- reported smoking or smoke-free status was recorded at registration with, and at discharge from, a midwife LMC. Findings: A trend of reduced smoking prevalence at registration was found for this NEW ZEALAND RESEARCH cohort (reduced from 19.5% in 2008 to 18.4% in 2010). Women who identified as Maori had the highest rates of smoking (42.9%) followed by Pasifika (15%) and NZ European ethnicity (13.4%). Women in the 16 to 19 years age group had the highest rate of smoking (39.4%) followed by the under 16 years age group (35.7%). Increasing parity was also associated with an increased likelihood of smoking at registration. By discharge from midwifery care there were reduced rates of smoking across all groups. Conclusion: Overall smoking during pregnancy prevalence rates are trending down with reduced rates of smoking across all groups by discharge from a midwife. Cessation messages and support need to be targeted to young women (under 25years), multiparous women and women of Maori ethnicity.

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midwife, pregnancy registration and discharge, Smoking