Maternal Smoking and Alcohol Use During Pregnancy in California, 19992004

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 trimesterno 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).
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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).
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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

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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)

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Ethnicity Place of Birth of Delivering Mothers,
MIHA 1999-2004
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Selected Characteristics of Recent Mothers,MIHA
1999-2004
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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 Mothers 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 Mothers 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.
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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