Smoking patterns during pregnancy and postnatal period and depressive symptoms

Department of Experimental Psychology, University of Bristol, Bristol BS8 1TU.
Nicotine & Tobacco Research (Impact Factor: 3.3). 12/2008; 10(11):1609-20. DOI: 10.1080/14622200802412895
Source: PubMed


We investigated the relationship between smoking status and depression symptom score in a large prospective cohort of women (n = 7,089) followed at regular intervals during and immediately following pregnancy. We wished to determine whether depression symptom score predicts subsequent likelihood of failed or successful smoking cessation attempts, and whether smoking cessation during and immediately following pregnancy is associated with change in depression symptom score. Longitudinal latent class analysis was used to empirically derive smoking trajectories. These latent smoking classes were characterized using adversity measures collected at baseline. Depression symptom score at baseline was used to attempt to predict class membership. The mean depression symptom score and change in depression symptom score was calculated within each smoking trajectory for each time point. We identified seven distinct smoking trajectories, with five reflecting a transition from smoking to nonsmoking, and in four of these a relapse back to smoking. Depression symptom score at baseline did not strongly differentiate between smoking trajectories. Those that resulted in abstinence demonstrated the lowest depression symptom scores at that time point. The analysis of change in depression symptom score suggested different relationships between depression symptom score, smoking cessation, and relapse among the various trajectories. Our data suggest the relationship between depression symptom score and smoking status may differ across the trajectories we identified. In general, smoking cessation appears to be associated with a reduction in depression symptom score. Future studies should explore this possibility in more detail, including whether these relationships differ in clinical and nonclinical samples.

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    • "Its symptoms include sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, irritability, feelings of loneliness, emotional lability, and even thoughts of harming oneself and/or the child [6]. Some significant risk factors for PPD include smoking [7,8], low levels of social support [9], low socioeconomic status, obstetric complications, and stressful life events during pregnancy [10]. Postpartum depression is associated with self-inflicted injury and morbidity for the mother [10] and poorer responsiveness to infant cues and disengaged parenting behaviours that ultimately lead to harmful cognitive and emotional development in infants [11]. "
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    ABSTRACT: Background Postpartum depression (PPD) is a mood disorder that affects 10–20 percent of women, and can begin any time during first year after delivery lasting for months. Social support may decrease risk of depression during pregnancy for women. However, literature shows that the amount of social support received during and after pregnancy is different for teen mothers and adult mothers. This study examined the effects of social support received during and after pregnancy on PPD among Canadian women and identified if the relationship was different for teen mothers compared to adult mothers. Methods The study was based on secondary analysis of the Maternity Experiences Survey. A total of 6,421 women with singleton live births, aged 15 years and older were analyzed. Teen mothers were identified as 15–19 years old and adult mothers were identified as 20 years and older. The main outcome of the study was PPD, which was evaluated using the Edinburg Postnatal Depression Scale. The main independent variable was social support received during pregnancy and after birth. Logistic regression was computed to assess the relationship between social support and PPD after adjusting for confounding variables and age as an interaction term. Adjusted Odds Ratios and 95% Confidence Intervals were reported. Results PPD was experienced by 14.0% among teen mothers and 7.2% among adult mothers (p < .001). Overall, teen mothers reported receiving more support during pregnancy and after birth than adult mothers (p < .010). The relationship between social support and PPD did not significantly differ for teen compared to adult mothers. Both teen and adult mothers were approximately five times more likely to experience PPD if they received no support or minimal support after the birth of the baby (95% CI, 3.51-7.36). Conclusion Receiving social support especially after birth is important for mothers of all ages to reduce the risk of PPD.
    BMC Pregnancy and Childbirth 05/2014; 14(1):162. DOI:10.1186/1471-2393-14-162 · 2.19 Impact Factor
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    • "Maternal smoking during pregnancy is the major preventable cause of poor health outcomes for women and their babies. Smoking during pregnancy causes substantial harm to mothers and infants, increasing the risks of post-natal depression, miscarriage, stillbirth, prematurity, low birth weight, perinatal mortality and morbidity, asthma, attention deficit disorder, learning difficulties, and obesity [1-6]. Smoking also presents immediate risks for the mother, including placental abruption [7], as well as the longer-term risks reported for smokers in general. "
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    ABSTRACT: Many women try to stop smoking in pregnancy but fail. One difficulty is that there is insufficient evidence that medications for smoking cessation are effective and safe in pregnancy and thus many women prefer to avoid these. Physical activity (PA) interventions may assist cessation; however, trials examining these interventions have been too small to detect or exclude plausible beneficial effects. The London Exercise And Pregnant smokers (LEAP) trial is investigating whether a PA intervention is effective and cost-effective when used for smoking cessation by pregnant women, and will be the largest study of its kind to date. The LEAP study is a pragmatic, multi-center, two-arm, randomized, controlled trial that will target pregnant women who smoke at least one cigarette a day (and at least five cigarettes a day before pregnancy), and are between 10 and 24 weeks pregnant. Eligible patients are individually randomized to either usual care (that is, behavioral support for smoking cessation) or usual care plus a intervention (entailing supervised exercise on a treadmill plus PA consultations). The primary outcome of the trial is self-reported and biochemically validated continuous abstinence from smoking between a specified quit date and the end of pregnancy. The secondary outcomes, measured at 1 and 4 weeks after the quit date, and at the end of pregnancy and 6 months after childbirth, are PA levels, depression, self-confidence, and cigarette withdrawal symptoms. Smoking status will also be self-reported at 6 months after childbirth. In addition, perinatal measures will be collected, including antenatal complications, duration of labor, mode of delivery, and birth and placental weight. Outcomes will be analyzed on an intention-to-treat basis, and logistic regression models used to compare treatment effects on the primary outcome. This trial will assess whether a PA intervention is effective when used for smoking cessation during pregnancy. Trial registration
    Trials 10/2012; 13(1):186. DOI:10.1186/1745-6215-13-186 · 1.73 Impact Factor
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    • "In line with previous studies (10, 17, 35), our primary analyses utilized a presence/absence measure of smoking. As with previous studies, we found evidence of a dose-dependent association between smoking during pregnancy and offspring ADHD (4). "
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    ABSTRACT: Maternal smoking during pregnancy is associated with attention deficit hyperactivity disorder (ADHD) in offspring. It is assumed by many that this association is causal. Others suggest that observed associations are due to unmeasured genetic factors or other confounding factors. The authors compared risks of maternal smoking during pregnancy with those of paternal smoking during pregnancy. With a causal intrauterine effect, no independent association should be observed between paternal smoking and offspring ADHD. If the association is due to confounding factors, risks of offspring ADHD should be of similar magnitudes regardless of which parent smokes. This hypothesis was tested in 8,324 children from a well-characterized United Kingdom prospective cohort study, the Avon Longitudinal Study of Parents and Children (data from 1991-2000). Associations between offspring ADHD and maternal and paternal smoking during pregnancy were compared using regression analyses. Offspring ADHD symptoms were associated with exposure to both maternal and paternal smoking during pregnancy (mothers: β = 0.25, 95% confidence interval: 0.18, 0.32; fathers: β = 0.21, 95% confidence interval: 0.15, 0.27). When paternal smoking was examined in the absence of maternal smoking, associations remained and did not appear to be due to passive smoking exposure in utero. These findings suggest that associations between maternal smoking during pregnancy and child ADHD may be due to genetic or household-level confounding rather than to causal intrauterine effects.
    American journal of epidemiology 07/2012; 176(3):261-8. DOI:10.1093/aje/kwr510 · 5.23 Impact Factor
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