Anales de Pediatría (English Edition) (Oct 2021)
Effects of active and/or passive smoking during pregnancy and the postpartum period
Abstract
Introduction: Tobacco smoking may cause adverse effects during pregnancy and postpartum. The aim of this study was to evaluate several repercussions of active and/or passive smoking by the mother at home, during pregnancy, at delivery, as well as for the newborn baby and breastfeeding, including the effect of quitting smoking in the first trimester of pregnancy. Methods: A prospective longitudinal study was carried out with a sample of 800 pregnant women. Four evaluations were made: first and third trimester of pregnancy, and 2 and 6/8 months postpartum. Sociodemographic, obstetric, health and tobacco consumption details were collected, with biochemical tests being performed to confirm the self-reported abstinence. Results: Being an active and passive smoker predicted suffering complications in pregnancy (OR 2.50; 95% CI; 1.42–4.35) and delivery (OR 3.10; 95% CI; 1.75–5.51), and also tended not to breastfeed (OR 2.44; 95% CI; 1.35–4.42). Being an active smoker predicted complications at childbirth (OR 5.58; 95% CI; 2.64–7.77), for the baby (OR 3.77; 95% CI; 1.53–9.36) and not breastfeeding at 2 (OR 25.73; 95% CI; 11.95–55.40), and 6/8 months postpartum (OR 6.61; 95% CI; 3.21–13.58). Being a passive smoker reduces the intend to breastfeed (OR 1.81; 95% CI; 1.11–2.95), and the practice of breastfeeding at 2 months postpartum (OR 1.94; 95% CI; 1.11–3.37). Women who quit smoking are less likely to suffer complications in pregnancy and childbirth, and are more likely to attend antenatal and breastfeeding classes, and to have babies with higher birth weight. Conclusions: Active and passive tobacco consumption has significant implications during pregnancy and postpartum period. Smoking cessation at the beginning of pregnancy reverses much of these effects. Resumen: Introducción: Fumar puede provocar efectos adversos durante el embarazo y el postparto. El objetivo de este estudio fue evaluar diversas repercusiones que puede acarrear el consumo de tabaco materno activo y/o pasivo en el hogar, en el embarazo, parto, recién nacido y en la lactancia materna, así como el efecto del abandono del tabaco en el primer trimestre de embarazo. Método: Estudio longitudinal prospectivo realizado con una muestra de 800 mujeres embarazadas. Se realizaron cuatro evaluaciones: primer y tercer trimestre de embarazo y 2 y 6/8 meses postparto. Se recogió información sociodemográfica, obstétrica, relacionada con la salud y con el consumo de tabaco, y se validó bioquímicamente el autoinforme de abstinencia. Resultados: Ser fumadora activa y pasiva predice sufrir complicaciones en el embarazo (OR 2,50; IC 1,42–4,35) y el parto (OR 3,10; IC 1,75–5,51) y tener la intención de no amamantar (OR 2,44; IC 1,35–4,42). Ser fumadora activa predice presentar complicaciones en el parto (OR 5,58; IC 2,64–7,77), el bebé (OR 3,77; IC 1,53–9,36) y no practicar lactancia materna a los 2 (OR 25,73; IC 11,95–55,40) y 6/8 meses postparto (OR 6,61; IC 3,21–13,58). Ser fumadora pasiva reduce la intención de amamantar (OR 1,81; IC 1,11–2,95) y la lactancia a los 2 meses postparto (OR 1,94; IC 1,11–3,37). Las mujeres que dejan de fumar presentan una menor probabilidad de sufrir complicaciones en el embarazo y el parto, mayor probabilidad de asistir a las clases preparto y de lactancia, y mayor peso de los recién nacidos. Conclusiones: El consumo de tabaco tanto activo como pasivo conlleva importantes repercusiones tanto en el embarazo como en el postparto. Dejar de fumar al inicio del embarazo revierte estos efectos.
