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  • 标题:Social Factors, Psychopathology, and Maternal Smoking During Pregnancy
  • 本地全文:下载
  • 作者:Stephen E. Gilman ; Joshua Breslau ; S.V. Subramanian
  • 期刊名称:American journal of public health
  • 印刷版ISSN:0090-0036
  • 出版年度:2008
  • 卷号:98
  • 期号:3
  • 页码:448-453
  • DOI:10.2105/AJPH.2006.102772
  • 语种:English
  • 出版社:American Public Health Association
  • 摘要:We investigated the relative importance of sociodemographic factors and psychiatric disorders for smoking among 453 pregnant women in the National Epidemiological Survey on Alcohol and Related Conditions. Women with less than a high school education and those with current-year nicotine dependence had the highest risk of smoking (90.5%), compared with women with a college degree and without nicotine dependence (3.9%). More effective and accessible interventions for nicotine dependence among pregnant smokers are needed. Maternal smoking during pregnancy increases the risk of birth complications 1 3 and has long-term developmental consequences for child development, including deficits in general intelligence, academic skills, and cognitive functioning. 4 7 As social inequalities in smoking have increased over time, 8 , 9 maternal smoking during pregnancy has become concentrated among women with lower levels of education (e.g., more than 20% among women without a high school degree). 10 14 In part, the relationship between education and continued smoking is attributable to nicotine dependence, which remains the most prominent obstacle to smoking cessation 15 19 and is associated with lower education. 20 Smoking during pregnancy may also be related to worse maternal mental health. 21 25 However, this evidence is not entirely consistent 26 28 and is based predominantly on clinical samples with above-average rates of psychopathology. In the general population, mood, anxiety, and substance-use disorders predict smoking initiation and persistence, 29 , 30 which suggests that treatment of maternal mental disorders (e.g., antidepressant pharmacotherapy or cognitive behavioral mood management) may promote smoking cessation and reduce fetal exposure to tobacco. 24 , 25 , 31 However, whether the focus of treatment should be on aspects of smoking behavior; symptoms of nicotine dependence 32 34 ; symptoms of concomitant mood, anxiety, or substance disorders; or a combination of these remains unresolved. We examined the independent associations of educational attainment, nicotine dependence, and common psychiatric disorders with maternal smoking during pregnancy.
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