Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Sociodemographic correlates of smoking in pregnancy and antenatal-care attendance in Indigenous and non-Indigenous women in South Australia

C. Mittiga A , K. Ettridge B , K. Martin A H , G. Tucker C D , R. Dubyna E , B. Catcheside C , W. Scheil F and L. Maksimovic G
+ Author Affiliations
- Author Affiliations

A Behavioural Research and Evaluation Unit, Cancer Council SA, PO Box 929, Unley BC, SA 5061, Australia.

B Population Health, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia.

C Health Statistics Unit, Epidemiology Branch, SA Health, PO Box 6 Rundle Mall, Adelaide, SA 5000, Australia.

D Discipline of Medicine, Level 3, Medical School South, University of Adelaide, SA 5005, Australia.

E Cancer Prevention Unit, Cancer Council SA, PO Box 929, Unley BC, SA 5061, Australia.

F Pregnancy Outcome Unit, Epidemiology Branch, SA Health, PO Box 6 Rundle Mall, Adelaide, SA 5000, Australia.

G Tobacco Control Unit, Quit SA, Cancer Council SA, PO Box 929, Unley BC, SA 5061, Australia.

H Corresponding author. Email: kmartin@cancersa.org.au

Australian Journal of Primary Health 22(5) 452-460 https://doi.org/10.1071/PY15081
Submitted: 3 June 2015  Accepted: 27 September 2015   Published: 30 November 2015

Abstract

Smoking in pregnancy is a key health issue in Australia, particularly among Indigenous women. However, few studies have examined the sociodemographic factors associated with smoking in pregnancy or the predictors of antenatal-care attendance among Indigenous and non-Indigenous Australian women who smoke. Data from the South Australian perinatal statistics collection of all births from 2000–2010 (n = 197 538) were analysed separately by Indigenous status to determine the sociodemographic factors associated with smoking in pregnancy and antenatal-care attendance by women who smoke. For Indigenous and non-Indigenous women, smoking in pregnancy was significantly independently associated with socioeconomic disadvantage, residing in regional or remote areas, increased parity, unemployment, being a public patient and attending fewer antenatal care visits. Smoking in pregnancy was associated with younger age and not being partnered only for non-Indigenous women. For Indigenous and non-Indigenous pregnant women who smoked, antenatal-care attendance was lower among women who were of younger age, higher parity, unemployed and not partnered. Differences in attendance within sociodemographic factors were greater for Indigenous women. Therefore, while sociodemographic correlates of smoking in pregnancy and antenatal-care attendance are largely similar for Indigenous and non-Indigenous women, tailored cessation and antenatal-care programs that reflect the differences in sociodemographic groups most at risk may be beneficial.


References

Australian Bureau of Statistics (2004) National Aboriginal and Torres Strait Islander social survey, 2002. Cat. no. 4714.0. (Australian Bureau of Statistics: Canberra).

Australian Bureau of Statistics (2010) National Aboriginal and Torres Strait Islander social survey, 2008. Cat. no. 4714.0. (Australian Bureau of Statistics: Canberra).

Australian Bureau of Statistics (2013) Estimates of Aboriginal and Torres Strait Islander Australians, June 2011. (Australian Bureau of Statistics: Canberra). Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3238.0.55.001Main+Features1June%202011?OpenDocument [Verified 9 October 2015]

Australian Bureau of Statistics (2011) Australian Standard Geographical Classification (ASGC) 2011. ABS cat. no. 1216.0. (Australian Bureau of Statistics: Canberra). Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/1216.0July%202011?OpenDocument [Verified 9 October 2015]

Australian Health Ministers’ Advisory Council (2012) Clinical Practice Guidelines: Antenatal Care – Module 1. (Department of Health and Ageing: Canberra). Available at http://www.health.gov.au/antenatal [Verified 12 October 2015]

Brown SJ, Yelland JS, Sutherland GA, Baghurst PA, Robinson JS (2011) Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care. BMC Public Health 11, 196
Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort: challenges and opportunities in antenatal care.Crossref | GoogleScholarGoogle Scholar | 21450106PubMed |

Cnattingius S (2004) The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine & Tobacco Research 6, S125–S140.
The epidemiology of smoking during pregnancy: smoking prevalence, maternal characteristics, and pregnancy outcomes.Crossref | GoogleScholarGoogle Scholar |

Commonwealth of Australia (2006) National clinical guidelines for the management of drug use during pregnancy, birth and the early development years of the newborn. NSW Department of Health, Sydney, NSW.

Dean AG, Dean JA, Control Centers for Disease Control (1994) ‘Epi Info, version 6: a word-processing, database, and statistics program for public health on IBM-compatible microcomputers.’ (Epidemiology Program Office, Centers for Disease Control and Prevention: Atlanta)

England LJ, Kendrick JS, Wilson HG, Merritt RK, Gargiullo PM, Zahniser SC (2001) Effects of smoking reduction during pregnancy on the birth weight of term infants. American Journal of Epidemiology 154, 694–701.
Effects of smoking reduction during pregnancy on the birth weight of term infants.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MrmsFOmsQ%3D%3D&md5=1cb4b4b9cf2d6794be7f58908f11b68fCAS | 11590081PubMed |

Gould GS, Munn J, Watters T, McEwen A, Clough AR (2013) Knowledge and views about maternal tobacco smoking and barriers for cessation in Aboriginal and Torres Strait Islanders: a systematic review and meta-ethnography. Nicotine & Tobacco Research 15, 863–874.
Knowledge and views about maternal tobacco smoking and barriers for cessation in Aboriginal and Torres Strait Islanders: a systematic review and meta-ethnography.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXmt1Snu7k%3D&md5=89b851b2d857633d3fe38f38c7289953CAS |

Hackshaw A, Rodeck C, Boniface S (2011) Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Human Reproduction Update 17, 589–604.
Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVyntr3F&md5=56873c28c7c30ed866524616ce8bc712CAS | 21747128PubMed |

Hodyl NA, Grzeskowiak LE, Stark MJ, Scheil W, Clifton VL (2014) The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia. The Medical Journal of Australia 201, 274–278.
The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia.Crossref | GoogleScholarGoogle Scholar | 25163379PubMed |

Hosmer DW, Lemeshow S 2000. ‘Applied logistic regression.’ (Wiley: New York)

Jaakkola JJ, Gissler M (2004) Maternal smoking in pregnancy, fetal development, and childhood asthma. American Journal of Public Health 94, 136–140.

Laws P, Grayson N, Sullivan EA (2006) Smoking and pregnancy. AIHW National Perinatal Statistics Unit, Sydney, NSW.

Li Z, Zeki R, Hilder L, Sullivan EA 2012. Australia’s mothers and babies 2010. AIHW National Perinatal Epidimiology and Statistics Unit, Canberra, ACT.

Linnet KM, Dalsgaard S, Obel C, Wisborg K, Henriksen TB, Rodriguez A, Kotimaa A, Moilanen I, Thomsen PH, Olsen J (2003) Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. The American Journal of Psychiatry 160, 1028–1040.
Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence.Crossref | GoogleScholarGoogle Scholar | 12777257PubMed |

McLean A, Scott J, Keane RJ, Sage L, Chan A 2001. Validation of the 1994 South Australian perinatal data collection form. Pregnancy Outcome Unit, Epidemiology Branch, Department of Human Services, Adelaide, SA.

Mohsin M, Bauman AE (2005) Socio-demographic factors associated with smoking and smoking cessation among 426,344 pregnant women in New South Wales, Australia. BMC Public Health 5, 138
Socio-demographic factors associated with smoking and smoking cessation among 426,344 pregnant women in New South Wales, Australia.Crossref | GoogleScholarGoogle Scholar | 16371166PubMed |

Mohsin M, Bauman AE, Forero R (2011) Socioeconomic correlates and trends in smoking in pregnancy in New South Wales, Australia. Journal of Epidemiology and Community Health 65, 727–732.
Socioeconomic correlates and trends in smoking in pregnancy in New South Wales, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MnltlCisQ%3D%3D&md5=bf90dd9332fb99c29aaeae82dc54e882CAS | 20841373PubMed |

Oken E, Levitan E, Gillman M (2008) Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis. International Journal of Obesity 32, 201–210.
Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7it1Wnuw%3D%3D&md5=50e13662f7ffe1f32a96f1fd2b7768baCAS | 18278059PubMed |

Passey ME, D’Este CA, Stirling JM, Sanson-Fisher RW (2012) Factors associated with antenatal smoking among Aboriginal and Torres Strait Islander women in two jurisdictions. Drug and Alcohol Review 31, 608–616.
Factors associated with antenatal smoking among Aboriginal and Torres Strait Islander women in two jurisdictions.Crossref | GoogleScholarGoogle Scholar | 22487020PubMed |

Passmore E, McGuire R, Correll P, Bentley J (2015) Demographic factors associated with smoking cessation during pregnancy in New South Wales, Australia, 2000–2011. BMC Public Health 15, 398
Demographic factors associated with smoking cessation during pregnancy in New South Wales, Australia, 2000–2011.Crossref | GoogleScholarGoogle Scholar | 25928643PubMed |

Phung HN, Bauman AE, Young L, Tran MH, Hillman KM (2003) Ecological and individual predictors of maternal smoking behaviour: looking beyond individual socioeconomic predictors at the community setting. Addictive Behaviors 28, 1333–1342.
Ecological and individual predictors of maternal smoking behaviour: looking beyond individual socioeconomic predictors at the community setting.Crossref | GoogleScholarGoogle Scholar | 12915173PubMed |

Pink B (2008) Information paper: an introduction to socio-economic indexes for areas (SEIFA), 2006. Australian Bureau of Statistics, Canberra, ACT.

SA Department of Health (2010) Aboriginal Health Care Plan 2010–2016. (Government of South Australia, Adelaide, SA. Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/1216.0July%202011?OpenDocument [Verified 9 October 2015]

Sainani K (2010) The importance of accounting for correlated observations. PM&R 2, 858–861.
The importance of accounting for correlated observations.Crossref | GoogleScholarGoogle Scholar |

Scott J, Chan A 2006. ‘South Australian perinatal statistics collection: guidelines for the supplementary birth record.’ (Pregnancy Outcomes Unit, South Australian Department of Health: Adelaide)

Thapar A, Fowler T, Rice F, Scourfield J, van den Bree M, Thomas H, Harold G, Hay D (2003) Maternal smoking during pregnancy and attention deficit hyperactivity disorder symptoms in offspring. The American Journal of Psychiatry 160, 1985–1989.
Maternal smoking during pregnancy and attention deficit hyperactivity disorder symptoms in offspring.Crossref | GoogleScholarGoogle Scholar | 14594745PubMed |

Thrift AP, Nancarrow H, Bauman AE (2011) Maternal smoking during pregnancy among Aboriginal women in New South Wales is linked to social gradient. Australian and New Zealand Journal of Public Health 35, 337–342.
Maternal smoking during pregnancy among Aboriginal women in New South Wales is linked to social gradient.Crossref | GoogleScholarGoogle Scholar | 21806728PubMed |

Tobacco Control Research and Evaluation Program (2011) ‘Key smoking statistics for South Australia 2010.’ (Tobacco Control Research and Evaluation, Cancer Council SA: Adelaide).

US Department of Health and Human Services (2004) The health consequences of smoking: a report of the Surgeon General. (US Department of Health and Human Services, Centers for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion: Atlanta).

US Department of Health and Human Services (2006) The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Available at http://www.surgeongeneral.gov/library/reports/secondhandsmoke/executivesummary.pdf [Verified 30 September 2015].

Walsh RA, Redman S, Brinsmead MW, Fryer JL (1997) Predictors of smoking in pregnancy and attitudes and knowledge of risks of pregnant smokers. Drug and Alcohol Review 16, 41–67.
Predictors of smoking in pregnancy and attitudes and knowledge of risks of pregnant smokers.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrivV2msA%3D%3D&md5=55eec0b095191f71b7dd92924a18e85fCAS | 16203410PubMed |

Winstanley M, van der Sterren A, Knoche D (2012) Tobacco use among Aboriginal peoples and Torres Strait Islanders. In Scollo MM, Winstanley MH editors ‘Tobacco in Australia: facts and issues’. (Cancer Council Victoria: Melbourne.) Available at http://www.tobaccoinaustralia.org.au/chapter-8-aptsi [Verified 9 October 2015]