دانلود رایگان مقاله مصرف دخانیات و ترک بی اختیار در سه ماهه اول بارداری

Abstract

Introduction: The purpose of this study was to examine the association between pregnant women's socio-demographic characteristics, smoking-related variables and psychological symptoms (anxiety and depression) and both tobacco consumption and spontaneous quitting at the first trimester of pregnancy. In particular, we wished to examine the contribution of depressive symptoms to tobacco consumption and spontaneous quitting, while controlling for anxiety symptoms, socio-demographic and smoking-related variables. Methods: The sample was comprised of 901 Spanish pregnant women. Assessment included an ad hoc questionnaire with socio-demographic and tobacco consumption information, the Edinburg Postnatal Depression Scale (EPDS), and The State-Anxiety Inventory (STAI-S). Two multiple logistic regression analyses were performed, respectively to predict tobacco consumption and to predict spontaneous quitting. Results: Having a partner who smokes (OR = 5.578), not having a college education (OR = 2.803), higher scores on the EPDS (OR = 1.073) and higher scores on the STAI-S (OR = 1.027) increase the probability of continuing smoking. Being primiparous (OR = 2.463), having a college education (OR = 2.141), smoking fewer cigarettes before pregnancy (OR = 1.175), and lower scores on the STAI-S (OR = 1.045) increase the probability of spontaneously quitting smoking at the first trimester of pregnancy. Conclusions: Depressive symptoms were a predictor of tobacco consumption but not of spontaneous quitting; spontaneous quitting was better predicted by anxiety symptoms. These findings support recommendations that women with depressive symptoms are at risk for smoking during pregnancy and highlight that anxious symptoms should be targeted in interventions for smoking cessation during pregnancy.

4. Discussion

In this sample of Spanish pregnant women, the prevalence of smoking in the first trimester was high (17.4%) and similar to rates observed in other studies (Maxson et al., 2012; Meghea et al., 2012; Smedberg et al., 2015). The pregnant smoker profile found in the present study corroborate that smokers tend not to cohabit with or have a partner (Dupraz et al., 2013; Goedhart et al., 2009; Maxson et al., 2012), are more likely to have a lower household income or lower socioeconomic status (Krstev et al., 2012; Maxson et al., 2012) and a lower educational level (De Wilde et al., 2013; Goedhart et al., 2009; Krstev et al., 2012; Linares-Scott et al., 2009; Maxson et al., 2012; Smedberg et al., 2015). Additionally, and consistent with prior research (De Wilde et al., 2013; Dupraz et al., 2013), pregnant smokers are more likely to have a partner who smokes, which indicates that household smoking is a significant risk factor for smoking, an assumption that is valid for the general smoking population. However, findings concerning age and parity in the current study do not match all results from the literature since no differences were found between smokers and nonsmokers in age or in parity. Furthermore, from a psychological point of view, higher percentages of depression and/or anxiety were also reported among pregnant smokers by previous studies (De Wilde et al., 2013; Eiden et al., 2011; Goedhart et al., 2009; Linares-Scott et al., 2009; Ludman et al., 2000; Varescon et al., 2013).