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Negative Effects of Prenatal Smoking on School Aged Children. Carrie Dawson PAS 646 Spring 2007 Advisor: Eileen Van Dyke. Background Information on Pregnancy and Smoking. 2001 CDC Report on Women and Smoking About 22% of women in US smoke About 28% of women in KY smoke
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Negative Effects of Prenatal Smoking on School Aged Children Carrie Dawson PAS 646 Spring 2007 Advisor: Eileen Van Dyke
Background Information on Pregnancy and Smoking • 2001 CDC Report on Women and Smoking • About 22% of women in US smoke • About 28% of women in KY smoke • 12-22% of women admit to smoking during pregnancy
Negative Effects that Prenatal Smoking is Causing in School Aged Kids • Physiologic Health Problems asthma, allergies, ear disease • Behavior and Psychiatric Disorders ADD, ADHD • Obesity
Asthma and Respiratory Health • In-utero exposure found to be greatest predictor of asthma diagnosis (Gilliand) • Prenatal smoking combined with low birth weight increased risk of asthma diagnosis at age 7 by 83% • Prenatal smoking and preterm delivery increased risk of asthma diagnosis at age 7 by 64%
Middle Ear Disease • 5 year olds were examined and were found to have more acute ear infections if prenatal smoking at any level had occurred • Increased risk of ear surgery if in-utero exposure was 20+ cigarettes a day
Behavior and Psychiatric Problems • Hyperkinetic disorders like ADHD three times more likely with maternal prenatal smoking • Severe behavior problems were 25% of the time attributable to prenatal changes of gene expression and nature/function of nicotinic receptors due to nicotine exposure
Obesity • Prenatal smoking was found to have same relationship to weight as “frequently” watching TV or playing video games • BMI and prevalence of being overweight in kids whose mothers stopped smoking during pregnancy found to be about the same as those whose mothers had never smoked
What does all this mean to us? • Increased cost to parents who have to deal with the health problems of these children • Increased cost to everyone because of increased health care costs to deal with these health problems
What can we do? • Patient Education – one study showed that one counseling session with a trained professional doubles the cessation rate among pregnant smokers • Teachable Moments – another study suggests pregnancy is one of the four most “teachable moments” in a patients life
Putting it Simply! • As we were told last semester, getting one person to stop smoking in our career will be a great accomplishment, imagine how sweet it would be if our one patient is a pregnant mom who can save her child a lifetime of health problems.
Bibliography • Benowitz et al. The use of Pharmacotherapy for Smoking Cessation During Pregnancy. Tobacco Control. 2000:9:iii91-iii94 • Chen et al. Maternal Smoking During Pregnancy in Relation to Child Overweight: Follow-up to Age 8 Years. International Journal of Epidemiology. 2006:35:121-130 • Eskenazi and Castorina. Association of Prenatal Maternal or Postnatal Child Environmental Tobacco Smoke Exposure and Neurodevelopmental and Behavioral Problems in Children. Environmental Health Perspectives. December 1999:107:991-1000 • Fergusson, Horwood and Lynskey. Maternal Smoking Before and After Pregnancy: Effect on Behavioral Outcomes in Middle Childhood. Pediatrics. 1993;92:815-822 • Gilliand, Li and Peters. Effects of Maternal Smoking During Pregnancy and Evironmental Tobacco Smoke on Asthma and Wheezing in Children. AmericanJournal of Respiratory and Critical Care Medicine. February 2001;163:429-436 • Jaakkola and Gissler. Maternal Smoking in Pregnancy, Fetal Development, and Childhood Asthma. American Journal of Public Health. 2004:94(1):136-141 • Kries et al. Maternal Smoking During Pregnancy and Childhood Obesity. American Journal of Epidemiology. 156:954-961 • Leary et al. Smoking During Pregnancy and Offspring Fat and Lean Mass in Childhood. Obesity. 2006:14:2284-2293 • Linnet et al. Maternal Lifestyle Factors in Pregnancy Risk of ADHD and Associated Behaviors: Review of the Current Evidence. American Journal of Psychiatry. 2003;160:1028-1040 • Linnet et al. Smoking During Pregnancy and the Risk for Hyperkinetic Disorder in Offspring. Pediatrics. 2005;116:462-467 • Mamun et al. Does Maternal Smoking During Pregnancy Have a Direct Effect on Future Offspring Obesity? Evidence From a Prospective Birth Cohort Study. American Journal of Epidemiology. 2006:164:317-325 • Maughan et al. Prenatal Smoking and Early Childhood Conduct Problems. Achives of General Psychiatry. August 2004:61(8)836-843 • McBride, Emmons and Lipkus. Understanding the potential of Teachable Moments: the Case of Smoking Cessation. Health Education Research. 2003;18(2):156-170 • Stathis et al. Maternal Cigarette Smoking During Pregnancy is an Independent Predictor for Symptoms of Middle Ear Disease at Five Years Postdelivery. Pediatrics. August 1999:104(2):e16 • Wakschlag et al. Maternal Smoking During Pregnancy and Severe Antisocial Behavior in Offspring: A Review. American Journal of Public Health. 92: 966 • Williams et al. Maternal Cigarette Smoking and Child Psychiatric Morbidity: A Longitudinal Study. Journal of American Academy of Pediatrics. July 1998:102(1):e11 • Women and Smoking – A Report of the Surgeon General 2001. http://www.cdc.gov/tobacco/sgr/sgr_forwomen/Executive_Summary.htm