Tobacco smoking primary survey of pregnant women in the maternity and child health service

Abstract

Introduction: Smoking of pregnant women can cause a number of complications in obstetrics and neonatology. Preventing them in Hungary, there is a pre-eminent option of collaboration between general practitioners and nurses of maternity and child health service in the primary care. Service nurses can assess the smoking habits of expectant mothers and collaborate with general practitioners in targeted smoking cessation/quitting programmes. Objective: testing such a programme, we arranged a pilot study in the maternity and child health service network of Nyíregyháza (a large city in Hungary) between October 1, 2019 and March 31, 2021 targeting all registered pregnant women. Method: The paper-based questionnaires were administered by the service nurses at the first visit of the pregnant women. 9 questions concerned basic biometric, socio-demographic, family planning data and (further 9 questions) especially cigarette smoking habits, environmental smoke, maternal and neonatal harms of smoking. Statistical analysis was performed by analyzing frequencies and cross-tabulation with significance level at p<0.05. Results: Reply was received by 87.9% (n = 1548) of the entire population (n = 1761). Average age of registered women was 30.2 (min./max. 15/48), first time visit to the service was in the 10.8th week (min./max. 6/34) of their pregnancy on average. Medium and higher level of education, 46.0% and 42.8%, respectively, was considerable. The proportion of Roma origin was 4.2%. Pregnancy was planned in 88.5%. Never smokers were 46.5%, past smokers were 55.3%. Current smokers were 10.1%, but 42.5% of former smokers admitted non-smoking status. Prevalence of passive smokers due to husband/partner smoking habit (n = 1493) was 30.3%. All participants knew exactly the harmful effect of smoking on the fetus. Conclusion: The role of higher education in urban environment was a significant contribution to the knowledge of harmful effects of smoking for the fetus. We found a significant difference to the disadvantage of Roma origin pregnant women in continued smoking during the pregnancy. As for environmental harmful effect, there was a clear disadvantage of nearly one third rate of husband’s/partner’s smoking. In rural and urban environment, the maternity and child health service provides a best option to detect the most endangered female population. Based on real data, collaborating general practitioners and service nurses can arrange the most effective way of tobacco smoking cessation/quitting during pregnancy.