A reexamination of smoking before, during, and after pregnancy.

Abstract

This study examined the patterns and correlates of maternal smoking before, during, and after pregnancy. We examined socioeconomic, demographic, and clinical risk factors associated with maternal smoking in a nationally representative cohort of women (n = 8285) who were surveyed 17 +/- 5 months and again 35 +/- 5 months after delivery. Smoking rates among women with a college degree decreased 30% from before pregnancy to 35 months postpartum but did not change among the least educated women. Risk factors clustered, and a gradient linked the number of risk factors (0, 2, 4) to the percentage smoking (6%, 31%, 58%, P <.0001). The period of pregnancy and early parenthood is associated with worsening education-related disparities in smoking as well as substantial clustering of risk factors. These observations could influence the targeting and design of maternal smoking interventions.