Smoking During Pregnancy Health Concern

grass During Pregnancy Health ConcernErin Chaplin Term Project denomination 1Topic Tobacco UseState IowaObjective TU-6 -TU-6 extend dope cessation during paternalism Increase take cessation during motherhoodIntroductionMaternal dumbbell during pregnancy is a key domain health concern in the United States. There atomic emergence 18 few instances in which environment has such a large effect on development as during pregnancy, which is considered a critical period.2 Prenatal factors down a large work out on a small frys ingathering and development, and can lead to health consequences that affect them for their whole lives.2Many women life littleness stack during pregnancy, condescension it being well known that it puts the baby at encounter of many a(prenominal) health worrys. There is a significant metre of scientific research proving the adverse effects of pot during pregnancy, and pregnant women ar discour timed from smoke piece of music pregnant.2 Howev er, it is report that as many as 14% of pregnant women in the US continue fume during pregnancy.1 smoke during pregnancy remains the most common cause of infant infirmity and conclusion, even though effective cessation methods exist.3 Public health is operative toward trying to decrease the preponderance of heater during pregnancy, however historical attainment has been unbend.3ImplicationsThe period of infant development during pregnancy has arguably the most with child(p) influence on a persons long border health and quality of life.2 Smoking during pregnancy can negatively influence growth and development to such an extent as to determine futurity health and behavior of the child.2There is plenty of evidence proving that the effects of smoke during pregnancy increases the risk of pregnancy complications such as fetal death (spontaneous abortion), fetal growth restriction (reduced render weight), placental complications, and premature delivery.1,2,3 Smoking in addit ion increases the risk of sudden infant death syndrome (SIDS) after pedigree.3 In 2002, 5%8% of preterm deliveries, 13%19% of term infants with growth restriction, 5%7% of preterm-related deaths, and 23%34% of deaths from sudden infant death syndrome (SIDS) were referable to prenatal smoking in the United States. 3 Children of mothers who smoked during pregnancy besides have increase risk for disease, health problems, and behavioral/ psychological issues later on in life.2There is evidence of a dose-response relationship, that increasing make sense of cigarette usage is related to increased risk of defects and complications.1,2 It has been guiden that nicotine crosses the placenta, and concentrations of nicotine in the baby can be as very much as 15% higher(prenominal) than concentrations in the mother.2 There is in addition evidence that women who smoke during pregnancy have an increased risk of having a baby with two or more than(prenominal) defects.1There are a surprisi ngly large number of un care physical birth defects that have been associated with significantly higher risk in women that smoke during pregnancy. There is a 9% increased risk associated with cardiovascular/heart birth defects.1 There is a 16% increased risk associated with musculoskeletal defects, such a limb reductions/underdevelopment.1 There is a 19% increased risk of facial defects, especially oral/facial clefts, with midpoint defects alone being greater than 25% increased risk.1 There is also increased risk of gastrointestinal defects and hernias.1 The most significant effects of smoking are seen in the occurrence and increased risk of limb reductions, baseball club foot, oral clefts, eye defects, and hernias.1 There is not sufficient evidence to show an association between maternal smoking and defects of the genitourinary, respiratory, or central head-in-the-clouds systems, though it is possible that smoking may have some effect.1 (See accessory B for Figure showing asso ciations of specific defects with smoking)In the US on that point are some 120,000 babies born each year with a birth defect, which is 3% incidence per year.1 Smoking while pregnant has been proven to be associated with significantly increased risk for a variety of defects including cardiovascular, musculoskeletal, gastrointestinal, facial, and more.1 Many of these birth defects are throw overboarde serious, result in physical and psychological illness, guide several painful and expensive surgical treatments throughout the infants life judgment of conviction, and may still result in a disability.1 In the US the estimated total expenditures for treating birth defects was approximately $2.1 billion in 2003.1 In 2004 approximately $122 million in healthcare costs for infants were attributed to maternal smoking.3 Thus it is a significant cost on the healthcare system for women to smoke while pregnant.Other studies have found behavioral and psychological associations between smoking during pregnancy and the childs abilities later in life.2 One demand suggests that maternal smoking negatively affects a childs livery and language development.2 Another study found an association with slighten wisdom in the child at age 4.2 There are also several studies that suggest an association with increased externalizing disorders, such as necessitate disorder and attention deficit/hyperactivity disorders (ADD/ADHD).2 Cognitive function has been shown to be adversely affected in through decreased attention span, response inhibition, memory, impulsivity, exposed language, verbal learning and design memory, problem solving, speech and language, school performance, and auditive processing.2It is important to also keep in mind that secondhand smoke after birth also increases a baby or childs risk for respiratory disease and infections, immune system problems like asthma and allergies, ear infections, sudden infant death syndrome (SIDS), and cancer later in life.2,3TrendsMa ternal smoking remains a common problem.2 It is reported that as many as 14% of pregnant women in the US continue smoking during pregnancy.1For most states the prevalence of smoking hasnt changed much over conviction however from 2000 to 2010 smoking prevalence actually decreased in parts of the US.3 In a subgroup of ten states the prevalence of smoking during pregnancy decreased from 13.3% to 12.3%, and smoking after birth decreased from 18.6% to 17.2% over the 11 year period.3 Sites that showed a significant decrease in maternal smoking from 2000 to 2010 include Colorado, Illinois, Minnesota, bleak Jersey, brand-new Mexico, New York, New York City, Utah, Washington, Wisconsin and Wyoming.3 New York City achieved the highest annual percentage decrease.3 Unfortunately in Louisiana, Maine, Mississippi, and atomic number 74 Virginia the prevalence of smoking during and after pregnancy actually increased over the time period.3 (See Figures on next page showing maternal smoking p revalence in US by time and location)In 2010 prevalence of smoking sooner pregnancy ranged from 9.2% in New York City to 46.2% in West Virginia, with an average of 23.2% of women that reported smoking during the 3 months before pregnancy.3 At the time whole New York City and Utah had achieved the muscular People 2020 inclination of decrease prevalence of smoking during the 3 months before pregnancy to 14%. 3Figure 1 from line 3 Figure 2 from Source 3In 2010 prevalence of smoking during pregnancy ranged from 2.3% in New York City to 30.5% in West Virginia, with an average of 10.7% of women that reported smoking during the last 3 months of pregnancy.3 At the time none of sites had yet achieved the lusty People 2020 goal of reducing prenatal smoking prevalence to 1.4%.3In 2010 the percentage of women that had smoked but arrest before the last trimester had increased significantly, especially in Illinois, Massachusetts, Michigan, and New Jersey.3 Unfortunately in Louisiana the n umber of women quitting smoking while pregnant actually decreased.3 In 2010 the percentage of women that quit smoking while pregnant ranged from 34.3% in West Virginia to 74.6% in New York City, with an average of 54.3% of women that reported quitting smoking during pregnancy.3 All sites with data available had achieved the Healthy People 2020 goal of increasing smoking cessation during pregnancy to 30%.3In 2010 the prevalence of smoking after birth had decreased significantly, it ranged from 4.1% in New York City to 37.5% in West Virginia, with an average of 15.9% of women that reported smoking 4 months after delivery.3In Iowa, from 2007 to 2012 the impetus overall has been an average of a 15% decrease in women that have smoked before and during pregnancy.4 Unfortunately, despite this downward trend, thither still remain 15% of women in Iowa that smoke during their first trimester, and 12% of women that smoke throughout their entire pregnancy.4 Awareness is helping, and there is n ow 41% of women in Iowa that smoked before pregnancy but quit while pregnant.4DisparitiesPrevalence of smoking during pregnancy varies widely depending on maternal age, ethnicity, education, and health insurance coverage.1,2,3 Priorities can be highlighted establish on this demographic information. In the US on average 20% of women less(prenominal) than 25 old age old smoke while pregnant, compared with only 9% of women 35 years or older.1 Also 22% of women with less than 12 years of education smoke while pregnant, compared with only 6.5% of women with greater than 12 years of education.1 Some studies have even suggested that the percentage of women under age 20 that are smoking while pregnant has increased.2Based on the demographic information presented in the Table in Appendix A, groups that neediness the most assistance are identified. It is easy to see a trend that women age 20-24, that are American Indian/Alaska Native, had 12 or less years of education, and had Medicaid cove rage (low income) were more likely to smoke before, during, and after pregnancy.3 Women that were less than 20 years old, Asian/Pacific Islander, had greater than 12 years of education, and had private insurance coverage were all more likely to quit during pregnancy.3 (See Appendix A for Table showing maternal characteristics in prevalence of prenatal smoking)ConclusionSmoking during pregnancy has been a continued problem within the US. Maternal smoking has been proven to increase risk for many birth defects.1 Educational information encouraging women to quit smoking before or during pregnancy needs to be stressed.1 Educational and policy efforts also need to be targeted especially toward women under age 24, with 12 or less years of school, in lower socioeconomic groups, because they are more likely to smoke while pregnant.1,3Efforts to reduce prevalence have only been mildly successful.3 In 2010 none of the states with data available had achieved the goal of reducing prevalence of prenatal smoking to 1.4%.3 If trends continue at the current slow rate then it could take another 100 years to refer that goal.3 Current tobacco control efforts in most states are credibly not adequate to be able to reach national goals in reducing the prevalence of smoking during pregnancy.3Appendix ATable 2 from Source 3 Appendix BFigure 1 from Source 1-Summary of the meta-analyses for maternal smoking in pregnancy and birth defects. The pooled ORs are shown for each body system and specific defects (total number of malformed cases in brackets). CI confidence interval 1ReferencesHackshaw A, Rodeck C, Boniface S. (2011) Maternal smoking in pregnancy and birth defects a systematic review based on 173 687 malformed cases and 11.7 million controls. Human Reproduction Update 2011 17589604. inside 10.1093/humupd/dmr022 URL http//humupd.oxfordjournals.org/content/early/2011/07/09/humupd.dmr022.fullKnopik VS, Maccani MA, Francazio S, McGeary JE. (2012). The epigenetics of maternal cigare tte smoking during pregnancy and effects on child development. Development and Psychopathology 2012 24(4)1377-1390. doi http//dx.doi.org.proxy.lib.uiowa.edu/10.1017/S0954579412000776.Tong VT, Dietz PM, Morrow B, DAngelo DV, Farr SL, Rockhill KM, England LJ. (2013). Trends in Smoking Before, During, and After Pregnancy Pregnancy happen Assessment Monitoring System, United States, 40 Sites, 20002010. Centers for Disease Control and measure (CDC) Morbidity and Mortality Weekly Report (MMWR) Surveillance Summaries 2013 62(6)1-19. URL http//www.cdc.gov/mmwr/pdf/ss/ss6206.pdfMuldoon, J. (2013) part of newborns exposed to maternal smoking, by county. IA Dept. Public Health Vital Records and vanity of Family Health, Div. Tobacco Use Prevention Control, IDPH 2013. URL http//www.idph.state.ia.us/IDPHChannelsService/file.ashx?file=787F5953-4D70-4563-A885-FCB2C9D3C185