Smoking prevalence and behaviours of Maltese mothers during pregnancy, associated factors and outcomes of delivery

Abstract

Despite the well documented adverse effects of smoking in pregnancy, literature shows that a significant number of women still continue to smoke throughout pregnancy. This study aims to explore the current prevalence of smoking in Maltese mothers and their behaviours throughout pregnancy and investigate for factors associated with smoking and outcomes of delivery. A descriptive, cross-sectional, retrospective survey was carried out. Data was collected using a structured face-to-face interview which was administered to the first 670 mothers who delivered a baby at Mater Dei Hospital between the months of October and December 2008. Out of the 670 mothers interviewed, 34% (227) stated that they had smoked at least 100 cigarettes in the past two years. The overall prevalence of mothers smoking throughout their pregnancy in this study was found to be 11.0%. A significant number of smoking mothers (50.2%) completely stopped smoking in the first trimester on getting to know they were pregnant. Those who did not stop showed a reduction in the number of cigarettes smoked as pregnancy progressed. Variables found to be significantly associated with smoking were; maternal age, education, marital status, region, living with a smoking husband/partner and unplanned pregnancies. Parity was not found to be associated with smoking status. Overall the participants were knowledgeable about the adverse effects of smoking, however a significant difference was found between the views and knowledge of smoking and non-smoking mothers. Findings' from this study also reveal a significant association between birth weight and the mother's smoking behaviour. This study found no statistically significant association between Apgar score, gestational age and maternal smoking. Mothers who smoked throughout pregnancy showed a higher interest in having access to smoking cessation programmes to help them stop smoking. Pregnancy provides a golden opportunity for the pregnant woman to stop smoking. The public health challenge lies in the ability to increase the rate of cessation at such an optimal time when woman are more disposed to modify their smoking behaviours and prevent relapse. A number of recommendations are drawn up to serve as guidelines for clinical practice, public health education and research.