The Cincinnati Children's Hospital Medical Center study, published in the November issue of the American Journal of Public Health, demonstrates that "health disadvantages associated with low maternal education are dynamic - they accrue over a time period that is rich in health care contacts," according to Robert Kahn, MD, the study's main author.
Dr. Kahn, a physician in Cincinnati Children's division of General and Community Pediatrics, likens the situation at-risk mothers face to a race, one in which women with less education start from behind and lose further ground as they progress through pregnancy and the birth of their children.
"A woman's level of education is the strongest predictor of whether she will smoke before, during and after pregnancy," says Dr. Kahn.
"It is important to appreciate that these women also face higher hurdles along the way, including poverty, depression and the powerful cues of other household smokers," he adds. "Ensuring continuous and comprehensive health services is critical for these women and for their children."
The study used data from the 1988 National Maternal and Infant Health Survey and 1991 follow-up. This survey of more than 8,000 women was designed to identify factors related to poor pregnancy outcomes. Dr. Kahn investigated factors associated with trends in maternal smoking over the course of pregnancy and three years postpartum.
Dr. Kahn discovered that smoking rates among women with a college degree decreased 30 percent from the period before pregnancy to three years after a birth. It did not change, however, among the least educated women. Risk factors for smoking included low income, living with another smoker, depression and alcohol use.
Cincinnati Children's Hospital Medical Center is a 373-bed institution dedicated to the pursuit of perfect health care. It is the only pediatric organization in the United States to receive the prestigious Pursuing Perfection grant from the Robert Wood Johnson Foundation. The Cincinnati Children's Research Foundation ranks third nationally among all pediatric centers in research grants from the National Institutes of Health. The Cincinnati Children's vision is to be the leader in improving child health, through patient care, research and education. Additional information about Cincinnati Children's can be found at www.cincinnatichildrens.org.