U.S. Department of Health and Human Services, Health Resources and Services Administration

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Smoking During Pregnancy

Smoking during pregnancy can have a negative impact on the health of women, infants, and children by increasing the risk of complications during pregnancy, premature delivery, and low birth weight—some of the leading causes of infant mortality.1Maternal cigarette use data are captured on birth certificates; however, a revised birth certificate was introduced in 2003 that captures smoking during pregnancy by trimester, as opposed to any time during pregnancy which is assessed with the unrevised birth certificate. As of 2007, the 1989 Standard Certificate of Live Birth (unrevised) was used in 24 States, New York City, and Washington, DC, while 22 States used the revised birth certificate.2

The areas using the revised birth certificate reported slightly higher rates of smoking during pregnancy than those using the unrevised certificate (10.4 versus 9.3 percent, respectively). The proportion of pregnant women who smoked cigarettes varied by maternal race and ethnicity. Among women in areas using the revised birth certificate, non-Hispanic American Indian/Alaska Native mothers (24.4 percent) and non-Hispanic White mothers (16.3 percent) were most likely to report having smoked during pregnancy.

Similarly, among women in the unrevised reporting areas, non-Hispanic American Indian/ Alaska Native mothers were most likely to have smoked during pregnancy (16.5 percent), followed by non-Hispanic White women (12.7 percent). Non-Hispanic Asian/Pacific Islander and Hispanic mothers were least likely to have smoked during regnancy in both reporting areas.

Cigarette use also varied by maternal age in 2007. Among women in the revised reporting areas, women under 20 years of age (14.0 percent) and those aged 20–29 years (12.9 percent) were more likely than older women to have smoked cigarettes during pregnancy. Similarly, 12.4 percent of women under 20 years of age and 11.5 percent of women aged 20–29 years in the unrevised reporting areas smoked during pregnancy.

1 U.S. Department of Health and Human Services. The health consequences of smoking: a report of the Surgeon General. 2004.
2 Martin JA, Hamilton BE, Sutton PD, Ventura SJ, et al. Births: Final data for 2006. National vital statistics reports; vol 57 no 7. Hyattsville, MD: National Center for Health Statistics. 2010. The 19 States using the 2003 Revision of the U.S. Standard Certificate of Live Birth were California, Delaware, Florida, Idaho, Kansas, Kentucky, Nebraska, New Hampshire, New York (excluding New York City), North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington, and Wyoming.

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