Publications (7) View all
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Article: Prenatal exposure to second hand smoke and adverse perinatal outcomes.
Evidence-based nursing 10/2011; 15(2):50-1. -
Article: The effects of prenatal secondhand smoke exposure on preterm birth and neonatal outcomes.
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ABSTRACT: To examine the relationship between prenatal secondhand smoke (SHS) exposure, preterm birth and immediate neonatal outcomes by measuring maternal hair nicotine. Cross-sectional, observational design. A metropolitan Kentucky birthing center. Two hundred and ten (210) mother-baby couplets. Nicotine in maternal hair was used as the biomarker for prenatal SHS exposure collected within 48 hours of birth. Smoking status was confirmed by urine cotinine analysis. Smoking status (nonsmoking, passive smoking, and smoking) strongly correlated with low, medium, and high hair nicotine tertiles (ρ=.74; p<.001). Women exposed to prenatal SHS were more at risk for preterm birth (odds ratio [OR]=2.3; 95% Confidence Interval [CI] [.96, 5.96]), and their infants were more likely to have immediate newborn complications (OR=2.4; 95% CI [1.09, 5.33]) than nonexposed women. Infants of passive smoking mothers were at increased risk for respiratory distress syndrome (RDS) (OR=4.9; 95% CI [1.45, 10.5]) and admission to a Neonatal Intensive Care Unit (NICU) (OR=6.5; CI [1.29, 9.7]) when compared to infants of smoking mothers (OR=3.9; 95% CI [1.61, 14.9]; OR=3.5; 95% CI [2.09, 20.4], respectively). Passive smokers and/or women with hair nicotine levels greater than .35 ng/ml were more likely to deliver earlier (1 week), give birth to infants weighing less (decrease of 200-300 g), and deliver shorter infants (decrease of 1.1-1.7 cm). Prenatal SHS exposure places women at greater risk for preterm birth, and their newborns are more likely to have RDS, NICU admissions, and immediate newborn complications.Journal of Obstetric Gynecologic & Neonatal Nursing 09/2010; 39(5):525-35. · 1.03 Impact Factor -
Article: Measuring prenatal secondhand smoke exposure in mother-baby couplets.
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ABSTRACT: Pregnant women often underreport their smoking status and extent of secondhand smoke (SHS) exposure. Biomarker confirmation is the recommended method to assess smoking behaviors and SHS exposure in both mothers and infants. Objectives: The primary aims are to (a) examine the relationship between smoking behaviors and SHS exposure in mother-baby couplets using maternal and infant hair nicotine and maternal urine cotinine analyses and (b) determine whether there is an association between maternal and infant hair nicotine samples obtained shortly after birth. A cross-sectional study with a multiethnic sample of 210 mother-baby couplets assessing SHS exposure. The level of maternal hair nicotine (MHN) was significantly different among three groups: nonsmoking, nonsmoking/passive exposed, and smoking (p < .0001), with nonsmoking and nonexposed women having the lowest level. Urine cotinine was strongly associated with self-reported smoking status (rho = .88; p < .0001). Maternal and infant hair nicotine were correlated, although MHN correlated more strongly with smoking status (rho = .46, p < .0001) than infant hair nicotine (rho = .39, p < .0001). Conclusions: MHN was a more precise biomarker of prenatal SHS exposure than infant hair nicotine; mothers' urine cotinine was strongly correlated with self-reported smoking status.Nicotine & Tobacco Research 02/2010; 12(2):127-35. · 2.58 Impact Factor -
Article: Nursing research in community-based approaches to reduce exposure to secondhand smoke.
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ABSTRACT: Secondhand smoke (SHS) is the third leading cause of preventable death in the United States and a major source of indoor air pollution, accounting for an estimated 53,000 deaths per year among nonsmokers. Secondhand smoke exposure varies by gender, race/ethnicity, and socioeconomic status. The most effective public health intervention to reduce SHS exposure is to implement and enforce smoke-free workplace policies that protect entire populations including all workers regardless of occupation, race/ethnicity, gender, age, and socioeconomic status. This chapter summarizes community and population-based nursing research to reduce SHS exposure. Most of the nursing research in this area has been policy outcome studies, documenting improvement in indoor air quality, worker's health, public opinion, and reduction in Emergency Department visits for asthma, acute myocardial infarction among women, and adult smoking prevalence. These findings suggest a differential health effect by strength of law. Further, smoke-free laws do not harm business or employee turnover, nor are revenues from charitable gaming affected. Additionally, smoke-free laws may eventually have a positive effect on cessation among adults. There is emerging nursing science exploring the link between SHS exposure to nicotine and tobacco dependence, suggesting one reason that SHS reduction is a quit smoking strategy. Other nursing research studies address community readiness for smoke-free policy, and examine factors that build capacity for smoke-free policy. Emerging trends in the field include tobacco free health care and college campuses. A growing body of nursing research provides an excellent opportunity to conduct and participate in community and population-based research to reduce SHS exposure for both vulnerable populations and society at large.Annual review of nursing research 01/2009; 27:365-91. -
Article: Postpartum smoking abstinence and smoke-free environments.
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ABSTRACT: The purpose of this exploratory study was to describe factors that contribute to successful postpartum smoking abstinence among women who quit smoking during pregnancy. Research questions addressed the primary motivators and lifestyle characteristics of women who do not return to postpartum smoking. Participants were recruited from a feasibility study (N = 16) based on their ability to remain smoke free for at least 6 months following delivery. Individual interviews were analyzed using content analysis strategies. Women's narratives described the process of postpartum smoking abstinence. Four themes emerged: (a) child's health as the primary motivator, (b) demanding a smoke-free home or environment, (c) smoking perception changes from one of primarily comfort to one of disgust, and (d) viewing abstinence as a lifelong change. Clinical implications include educating families about the effects of smoke-free environments on the health of their children while redirecting smoking habits with healthy behaviors.Health Promotion Practice 01/2011; 12(1):126-34.
