Least Explored Factors Associated with Prenatal Smoking

The study was performed to identify the impact of maternal smoking during pregnancy on pregnancy outcomes, as well as infant morbidity and mortality. The study had an ulterior objective of showing how maternal smoking is correlated with detrimental health conditions in infants and children such as viral and bacterial infections and periodontal diseases. The study has also examined some of the risk factors associated with prenatal smoking with the main one being maternal depression (Masho et al., 2012). The research question is the least explored factors that have been associated with prenatal smoking.

The design of the study is a quantitative approach because it gathers information that focuses on the description of a phenomenon in a succinct and comprehensive manner.  The problem has been quantified through generation of numerical data that is applicable in usable statistics. The design method that was applied is cohort study because a certain group of population that was exposed to prenatal smoking was compared with the other group that was not exposed to prenatal smoking. The resulting differences were subsequently used in the examination of factors that pertain to antenatal smoking (Masho et al., 2012). The design was appropriate because the quantitative data obtained from the research formulate facts by using measurable data that can shed light on the research question. In addition, the use of facts and figures to arrive at conclusions yields reliable information that is backed by facts and figures.

The sampling strategy used was a randomized clinical trial in a health facility that serves women who are more likely to be pregnant and in need of intensive prenatal care.  The subject used was a clinical procedure to determine the eligibility of women in a randomized clinical trial. The number of women that were included in the study was 921 even though only 902 undertook the study in its entirety. The inclusion or exclusion criteria that would guarantee the eligibility of selection in the study were that the women had to be above 16 years of age, pregnant, African American and native English speakers. In addition, the participants had to attend a prenatal care visit which would probably be their first visit. In the study, protection of human subjects was guaranteed because it had been approved by Virginia Commonwealth University’s Institutional Review Board (VCU-IRB) (Masho et al., 2012).

Variables studied comprised both dependent and independent variables. The dependent variables included the last time the participants smoked a cigarette.  The responses to the question were: never smoked, smoked in the course of the day, never smoked for the past week, never smoked for the last three months, never smoked for the past six months, never smoked for the past year and never smoked for more than a year ago.  The independent variables in the study placed reliance on the responses obtained from the dependent variables. In this regard, those who had smoked in the course of the day were perceived as smokers while those that had not engaged in smoking activities that day were non-smokers.  Another independent variable was the separate analysis conducted within a one-month interval in the quest of examining some of the factors that were prevalent among women who occasionally engaged in smoking activities (Masho et al., 2012). The instruments that had been applied were questionnaires and survey instruments. The survey instruments comprised items that pertained to demographics of the students, history of substance use and socioeconomic characteristics to mention just a few. The instrument used in the questionnaire was a two item patient health questionnaire.  The measures of instrument reliability pertained to three item partner violence screen that was subject to validation in the health care setting. Partner violence screen was used for risk ascertainment for any domestic that took place. The instrument was questioning the participants on the safety they derive from their relationships and whether there is a partner that compromises the overall safety of the participant.

Data analysis or statistical test was a descriptive analysis that comes in handy in assessing distribution of demographics, as well as behavioral and social characteristics of survey respondents. In addition, there was unadjusted relationship subsisting between smoking prevalence and studying habits.  A distinct regression analysis was also conducted for the purpose of assessment of factors that had close liaison with prenatal smoking among participant smokers. However, the models that had variables contributing to the best fit model were retained so as to be further extrapolated for the sole purpose of research results.

The results of the study showed that out of 902 women that had been researched, only 898 came up with a valid response in reference to the smoking question (Masho et al., 2012). That was about 99.6% of the population.  17% of women accepted to have smoked in the course of the day of their prenatal visits while other 26% and 32% had smoked during the past week and the last 30 days respectively (Masho et al., 2012). A vast majority of participants acquired a high school education and were still unemployed. In addition, most of them were single even though they had a public insurance.  The results were important in drawing the correlation between smoking within a month prior to the prenatal care and employment status, level of education, illicit drug use and criminal history.

The limitation of the study is that the data that was used during the examination of smoking status was self-reported data. However, as a result of social desirability, there might be a possibility that smokers may have been wrongly classified as non-smokers (Masho et al., 2012).  The implication this might have had is an underestimation of some of the variables that were used in the study which means that the final data will not be as reliable.  The limitation is attributable to the fact that pregnant women have a tendency not to disclose their smoking habits. Non-disclosure of such information is more prevalent among the Hispanic blacks.  In addition, the study could not come up with detailed investigations of the roles of other factors, such as smoking habits of their partners. Another limitation of the study is that the rations that have been reported are only odd ratios as opposed to prevalence odd ratios which may have an impact of overestimating the association. 

Nurses may use the study results to consider screening pregnant smokers for depression and aiding with the provision of treatment options.  While considering screening, nurses should also acknowledge that depressed smokers will be more susceptible to challenges as they try to quit their habits as compared to non-depressed smokers.  Nurses should note that deleterious repercussions of smoking can only be prevented by refraining from smoking especially during the months prior to the pregnancy. Moreover, because of the correlation between possibility of smoking habits and criminal history, nurses should take the initiative and investigate criminal records of a patient because the findings might be a vital predictor of prenatal smoking. The socio-demographic factors should not be neglected as they might come in handy in shedding light on prenatal smoking habits.