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Maternal Smoking and Alcohol Use During Pregnancy in California, 1999-2004

Maternal Smoking and Alcohol Use During Pregnancy in California, 1999-2004. Amy Godecker, PhD Kristen S. Marchi, MPH University of California, San Francisco Eugene R. Takahashi, PhD Shabbir Ahmad, DVM MS PhD Epidemiology and Evaluation Section

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Maternal Smoking and Alcohol Use During Pregnancy in California, 1999-2004

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  1. Maternal Smoking and Alcohol Use During Pregnancy in California, 1999-2004 Amy Godecker, PhD Kristen S. Marchi, MPH University of California, San Francisco Eugene R. Takahashi, PhD Shabbir Ahmad, DVM MS PhD Epidemiology and Evaluation Section Maternal, Child and Adolescent Health/Office of Family Planning Branch California Department of Health Services December 8, 2005

  2. Adverse Outcomes: Alcohol Use During Pregnancy • No known safe level of alcohol use • ACOG & AAP recommend NO alcohol use at all • Problems in each trimester—no safe period • Increased risk of • Fetal alcohol spectrum disorders/FAS • Alcohol-related birth defects • Cardiac, skeletal, renal, ocular, auditory • Alcohol-related neurodevelopmental disorder • Small for gestational age See AAP Committee on Substance Abuse & Committee on Children with Disabilities. (2000).

  3. Adverse Outcomes: Smoking During Pregnancy • Increased risk of • Placental complications • Small for gestational age • Preterm birth • Fetal death, stillbirth, neonatal mortality • Cleft lip/palate • SIDS • Respiratory illness • Dose response for many outcomes See Cnattinguius S. (2004); Ashmead GG. (2003); Cornelius MD, Day NL. (2000).

  4. Healthy People 2010 • Alcohol • Goal: 94% of pregnant women did not drink in past month • Tobacco • Goal: 99% of pregnant women did not smoke in past month • California measures 1st & 3rd trimester use

  5. Maternal and Infant Health Assessment (MIHA) 1999-2004 • Representative of California women who had a live birth • Survey conducted in English & Spanish • Mail survey with telephone follow-up for non-respondents • Completed 2-7 months postpartum • Annual response rates 70-74% • Total N = 21,269 (~3,500 per year)

  6. Ethnicity & Place of Birth of Delivering Mothers, MIHA 1999-2004

  7. Selected Characteristics of Recent Mothers,MIHA 1999-2004

  8. Alcohol Use During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  9. Alcohol Use During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  10. Alcohol Use During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  11. Alcohol Use During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  12. Average Number of Drinks Per Week, 1st & 3rd Trimesters, California, 1999 & 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  13. Alcohol Use During Pregnancy, by Race/Ethnicity, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  14. Alcohol Use During Pregnancy, by Family Income, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  15. Alcohol Use During Pregnancy, by Mother’s Age, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  16. Smoking During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  17. Smoking During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  18. Smoking During Pregnancy, California, 1999-2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  19. Average Number of Cigarettes Per Day, 1st & 3rd Trimesters, California, 1999 & 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  20. Smoking During Pregnancy, by Race/Ethnicity, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  21. Smoking During Pregnancy, by Family Income, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  22. Smoking During Pregnancy, by Mother’s Age, California, 2004 Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  23. Risk of Smoking for Drinkers Relative to Non-Drinkers, 1st & 3rd Trimesters, California, 2004 * *Estimate based on small number of cases. Data Source: Maternal and Infant Health Assessment, California Department of Health Services, Maternal, Child and Adolescent Health/Office of Family Planning Branch, 1999-2004.

  24. Summary • Alcohol use 1st trimester modest decline 1999-2004 • Smoking 1st & 3rd trimester declines 1999-2004 • Smoking higher among White & African-American women, low-income & younger women • Likelihood of smoking increases with heavier alcohol use

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