Review
Predictors of smoking cessation during pregnancy: a systematic review and meta-analysis
Muhammad Riaz,
Sarah Lewis,
Felix Naughton,
Michael Ussher,
Corresponding Author
Muhammad Riaz
College of Medicine, Biological Sciences and Psychology, Department of Health Sciences, University of Leicester, Leicester, UK
Correspondence to: Muhammad Riaz, College of Medicine, Biological Sciences and Psychology, Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK. E-mail: [email protected]Search for more papers by this authorSarah Lewis
Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
Search for more papers by this authorFelix Naughton
School of Health Sciences, University of East Anglia, Norwich, UK
Search for more papers by this authorMichael Ussher
Population Health Research Institute, St George's University of London, London, UK
Search for more papers by this authorMuhammad Riaz,
Sarah Lewis,
Felix Naughton,
Michael Ussher,
Corresponding Author
Muhammad Riaz
College of Medicine, Biological Sciences and Psychology, Department of Health Sciences, University of Leicester, Leicester, UK
Correspondence to: Muhammad Riaz, College of Medicine, Biological Sciences and Psychology, Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK. E-mail: [email protected]Search for more papers by this authorSarah Lewis
Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
Search for more papers by this authorFelix Naughton
School of Health Sciences, University of East Anglia, Norwich, UK
Search for more papers by this authorMichael Ussher
Population Health Research Institute, St George's University of London, London, UK
Search for more papers by this authorAbstract
Aim
To identify factors found in the research literature to be associated with smoking cessation in pregnancy.
Methods
Electronic searches of the bibliographic databases of PubMed, EMBASE, PsycINFO, Elsevier, Scopus and ISI Web of Science were conducted to April 2017. All studies reporting factors associated with smoking cessation or continuing smoking during pregnancy were included and reviewed systematically, irrespective of study design. The Newcastle–Ottawa Quality Assessment Scale was used to assess the study quality. The DerSimonian & Laird random-effects model was used to conduct meta-analyses, and where effect estimates were reported for factors included in at least three studies.
Results
Fifty-four studies, including 505 584 women globally who smoked before pregnancy, 15 clinical trials and 40 observational studies, were included in the review and 36 (65.5%) were considered to be of high quality. This review identified 11 socio-demographic, seven socially related, 19 smoking behaviour-related, five pregnancy-related, six health-related and six psychological factors that were associated significantly with smoking cessation during pregnancy. The most frequently observed significant factors associated with cessation were: higher level of education, pooled odds ratio (OR), 95% confidence interval (CI) = 2.16 (1.80–2.84), higher socio-economic status: 1.97 (1.20–3.24), overseas maternal birth: 2.00 (1.40–2.84), Medicaid coverage or private insurance: 1.54 (1.29–1.85), living with partner or married: 1.49 (1.38–1.61), partner/other members of the household do not smoke: 0.42 (0.35–0.50), lower heaviness of smoking index score: 0.45 (0.27–0.77, lower baseline cotinine level: 0.78 (0.64–0.94), low exposure to second-hand smoking: 0.45 (0.20–1.02), not consuming alcohol before and/or during pregnancy: 2.03 (1.47–2.80), primiparity: 1.85 (1.68–2.05), planned breastfeeding:1.99 (1.94–2.05), perceived adequate pre-natal care: 1.74 (1.38–2.19), no depression: 2.65 (1.62–4.30) and low stress during pregnancy: 0.58 (0.44–0.77).
Conclusion
A wide range of socio-demographics, relationship, social, smoking-related, pregnancy-related, health and psychological factors have been found to predict smoking cessation in pregnancy.
Supporting Information
| Filename | Description |
|---|---|
| add14135-sup-0001-supplementary_tables.docxWord 2007 document , 170.2 KB |
Table S1 Characteristics of studies included in the systematic review. Table S2 Scores using Newcastle Ottawa Quality Assessment Scale (NOQAS) for cohorta studies. Table S3 Scores using modified Newcastle Ottawa Quality Assessment Scale (MNOQAS) for cross-sectional studies. Figure S2 Forest plots: pooled(c,h,i) odds ratios(a,b) for the factors associated significantly with smoking cessation during pregnancy reported by three or more studies. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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