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      Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey : Associação de fatores de risco com tabagismo durante a gravidez em mulheres em idade fértil: estudo epidemiológico de campo na Turquia

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      I ,
      São Paulo Medical Journal
      Associação Paulista de Medicina - APM
      Smoking, Prevalence, Women, Pregnancy, Gestational age

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          ABSTRACT

          CONTEXT AND OBJECTIVE:

          Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy.

          DESIGN AND SETTING:

          A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014.

          METHODS:

          The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis.

          RESULTS:

          The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy.

          CONCLUSIONS:

          Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.

          RESUMO

          CONTEXTO:

          Fumar durante a gravidez é um fator de risco importante para a saúde materna e infantil e que pode ser evitado. O estudo teve como objetivo investigar os fatores de risco associados com o comportamento de fumar durante a gravidez.

          TIPO DE ESTUDO E LOCAL:

          Inquérito por amostragem probabilística de base domiciliar de 1.510 mulheres foi realizado no centro da cidade de Sivas, Turquia, entre setembro de 2013 e maio de 2014.

          MÉTODOS:

          A prevalência do hábito de fumar durante a gravidez foi estimada de acordo com as variáveis independentes por meio da análise de regressão.

          RESULTADOS:

          A prevalência do hábito de fumar durante a gravidez foi de 16,5%. A regressão logística mostrou que estar em idade relativamente jovem (odds ratio, OR = 1,92, P = 0,025 por grupo de idade 15-24e OR = 2,45, P = 0,001 para a faixa etária 25-34), com alto nível de escolaridade (OR = 1,76, P = 0,032), sendo solteira (OR = 1,48, P = 0,002) e vivendo em família grande (OR = 1,98, P = 0,009) foram os fatores associados ao risco de fumar durante a gravidez. Parto prematuro e baixo peso ao nascer foram mais frequentes entre as fumantes.

          CONCLUSÕES:

          Atenção sistemática deve ser dada às desigualdades socioeconômicas para apoiar mulheres a parar de fumar antes ou na fase inicial da gravidez, tendo como alvo mulheres mais jovens, e particularmente aquelas de grupos socioeconômicos mais desfavorecidos. Isso conduzirá a um melhor estado de gravidez em mulheres, especialmente às jovens.

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          Most cited references39

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          Smoking prevalence and cigarette consumption in 187 countries, 1980-2012.

          Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress. To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012. Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38,315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day. Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year. Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%; P < .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%; P < .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%; P = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million-742 million) in 1980 to 967 million (95% UI, 944 million-989 million; P < .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence. Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world's population, intensified efforts to control its use are needed.
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            Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly?

            In this paper, we review the evidence bearing on socio-economic disparities in pregnancy outcome, focusing on aetiological factors mediating the disparities in intrauterine growth restriction (IUGR) and preterm birth. We first summarise what is known about the attributable determinants of IUGR and preterm birth, emphasising their quantitative contributions (aetiological fractions) from a public health perspective. We then review studies relating these determinants to socio-economic status and, combined with the evidence about their aetiological fractions, reach some tentative conclusions about their roles as mediators of the socio-economic disparities. Cigarette smoking during pregnancy appears to be the most important mediating factor for IUGR, with low gestational weight gain and short stature also playing substantial roles. For preterm birth, socio-economic gradients in bacterial vaginosis and cigarette smoking appear to explain some of the socio-economic disparities; psychosocial factors may prove even more important, but their aetiological links with preterm birth require further clarification. Research that identifies and quantifies the causal pathways and mechanisms whereby social disadvantage leads to higher risks of IUGR and preterm birth may eventually help to reduce current disparities and improve pregnancy outcome across the entire socio-economic spectrum.
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              • Article: not found

              WHO report on the global tobacco epidemic, 2008: The MPOWER package

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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                03 April 2017
                2017
                : 135
                : 2
                : 100-106
                Affiliations
                [I ] originalMD. Professor, Department of Public Health, School of Medicine, Cumhuriyet University, Sivas, Turkey.
                Author notes
                Address for correspondence: Naim Nur. Department of Public Health, School of Medicine, Cumhuriyet University, 58140 Sivas - Turkey. Tel. + 90 346 2191010/2125. Fax. + 90 346 2191155. E-mail: naimnur@ 123456yahoo.com

                Conflict of interest: None

                Article
                10.1590/1516-3180.2016.021921102016
                9977337
                28380202
                4c2f0e3c-35d2-48b6-99ea-e82af00d8137
                © 2022 by Associação Paulista de Medicina

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 15 October 2016
                : 21 October 2016
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 32, Pages: 07
                Categories
                Original Article

                smoking,prevalence,women,pregnancy,gestational age
                smoking, prevalence, women, pregnancy, gestational age

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