Associations of maternal obesity and smoking status with perinatal outcomes

Abstract

Maternal obesity and smoking are associated with adverse perinatal outcomes. These prevalent conditions contribute to health disparities. In this study, we examine whether maternal BMI moderates the impact of smoking cessation on short-term perinatal outcomes. This is a secondary analysis of assessments conducted from several prospective clinical trials examining the efficacy of incentives to promote smoking cessation during pregnancy. Participants were randomly assigned to receive financial incentives contingent upon smoking abstinence or a control condition. Pregnancy outcomes were abstracted from the medical record. ANCOVA and multiple logistic regression were used for statistical analysis. Among 388 women, there was a significant interaction between maternal pre-pregnancy BMI and smoking status on gestational age at delivery (p = .03) and admission to the NICU (p = .04). Among underweight/normal weight gravidas, smoking resulted in earlier deliveries and a greater likelihood of NICU admission than in those who abstained. Among overweight/obese gravidas, there was no effect of smoking on gestational age at delivery and infants of smokers were less likely to be admitted to the NICU. Maternal obesity and smoking have significant individual effects on perinatal outcome. Maternal overweight/obesity appears to moderate the effect of smoking on gestational age at delivery and on NICU admissions.

Keywords:

• Pregnancy
• smoking
• obesity
• premature birth
• smoking cessation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse (NIDA) and Food and Drug Administration (FDA) center grant P50DA036114, National Institutes of General Medical Sciences (NIGMS) center grant P20GM103644, NIDA research grant R01DA14028, and National Institute of Child Health and Human Development (NICHD) and Centers on Disease Control and Prevention (CDC) research grant R01HD75669. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA, FDA, NIGMS, NICHD, or CDC.