The impact of smoke-free legislation on educational differences in birth outcomes

Datos Bibliográficos

ID11174264
AutoresBritt Mckinnon (0000-0002-3109-5474, Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada, autor de correspondencia), Nathalie Auger (0000-0002-2412-0459, Institut national de santé publique du Québec, Montreal, Quebec, Canada), Jay S Kaufman (0000-0003-1606-401X, Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada)
Año2015
Volumen69
Número10
Páginas937-943
Fecha de publicación2015-10-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaJournal of Epidemiology and Community Health (JOURNAL)
Identificadores de la revistaISSN: 0143-005X • E-ISSN: 1470-2738
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/jech-2015-205779
PMID25987722
OpenAlexW2128324687
IdiomaEN
Citas recibidas3
Referencias citadas27

BACKGROUND: Smoke-free legislation may have positive effects on birth outcomes. Given that smoking and secondhand smoke during pregnancy vary with socioeconomic position, legislation may have greater effects in some socioeconomic groups. For this study, we evaluated the impact of a 2006 ban on smoking in public places in the Canadian province of Quebec on preterm birth, small-for-gestational-age birth and birth weight, and on educational differences in these birth outcomes. METHODS: We analysed data on singleton births in Quebec between 2003 and 2010. Logistic regression was used to model the association of smoke-free legislation with preterm birth (<37 weeks), very preterm birth (<34 weeks), small-for-gestational-age birth (<10th centile for gestational age and sex), low birth weight (<2500 g) and mean birth weight, adjusting for secular trends before and after legislation. Interaction terms were included to assess differential effects by level of maternal education. RESULTS: Smoke-free legislation was associated with average reductions of 3.1 preterm births (95% CI 0.1 to 6.0), 2.3 very preterm births (95% CI 0.9 to 3.7), 5.9 small-for-gestational-age births (95% CI 2.6 to 9.3) and 1.0 low birthweight infants (95% CI 0.4 to 1.6) per 1000 live births, as well as a 17.1 g increase in mean birth weight (95% CI 10.7 to 23.6). Legislation was associated with improved birth outcomes in all categories of maternal education. CONCLUSIONS: Smoke-free legislation in Quebec was associated with reductions in preterm and small-for-gestational-age births, and an increase in birth weight. There was no compelling evidence that legislation impacted educational gradients in birth outcomes

Birth weight · Environmental health · Gestational age · Legislation · Low birth weight · Obstetrics · Population · Pregnancy · Premature birth · Small for gestational age · Socioeconomic status · Cancer Risks and Factors · Demography · Gestational Diabetes Research and Management · Medicine · Smoking Behavior and Cessation · Pediatrics