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 Plenty of previous research has linked smoking during pregnancy and
exposure to second-hand smoke to premature deliveries - babies that
arrive before 37 weeks gestation. Less is known about how specific
government efforts to prohibit smoking in public areas can impact
premature birth rates.
Researchers analyzed data for almost 450,000 babies born in
Switzerland from 2007 to 2012 and found 5 percent were premature and
another 27 percent arrived between 37 and 38 weeks gestation – which
the research team calls "early term."
The introduction of smoking bans during the study period was
associated with a 5 percent reduction in early-term births.
Premature births also declined 3.5 percent with the debut of smoking
bans, but this decline was too small to rule out the possibility
that it was due to chance or caused by something else.
"We found that only more comprehensive smoke-free laws showed
benefits for preterm births," said lead study author Dr. Ana Vicedo-Cabrera
of the University of Basel in Switzerland.
"We also found that the more time a pregnant woman is covered by a
smoking ban, the greater the benefits are in terms of reduction of
the risk of having a preterm baby," Vicedo-Cabrera added by email.
In Switzerland, smoking in public places is regulated at both the
federal and cantonal, or regional, level. A federal smoking ban
approved in 2010 barred smoking in most public places and
workplaces, but made several exceptions for the hospitality sector
and allowed smoking rooms in larger establishments.
At that time, 12 of 26 cantons already had regional smoking bans in
place, most with a higher level of protection for hospitality
workers, researchers note in the journal Tobacco Control.
Because most babies in the study were born full term, researchers
only found fractional differences in the risk of early arrivals, and
the magnitude of many of the findings wasn't large enough to be
statistically meaningful.
Nonetheless, regions with the most comprehensive smoking bans that
extended to places like restaurants had almost a 7 percent reduction
in preterm births, with drops as high as about 12 percent in some
areas.
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One limitation of the study is that researchers looked only at
smoking bans in regions where women lived, which might differ from
policies where they worked, the authors note. Researchers also
lacked data on whether women or people in their households changed
smoking habits during the study period.
Even so, the study's findings add to a growing body of evidence
suggesting that smoking bans can benefit babies, said Karla
Bartholomew, a public health researcher at George Washington
University in Washington, D.C. who wasn't involved in the study.
"This study adds to the literature by extending its findings to
early-term births," Bartholomew said by email. "Over the past
several years, there has been a greater recognition that the health
of newborns varies across the five-week "term-window" (37 to 42
weeks) with the greater risks earlier in the window."
Without smoking bans, women can still take steps to avoid cigarette
exposure during pregnancy, noted Dr. Thomas Northrup, a researcher
in family and community medicine at McGovern Medical School in
Houston, Texas, who wasn't involved in the study.
"We recommend avoiding homes, restaurants, laundromats, and any
other facilities where there is active smoking," Northrup said by
email.
"No exposure during any trimester of pregnancy has been demonstrated
to be safe," Northrup added. "Exposure during the third trimester is
most strongly associated with health risks so we would caution
pregnant women to avoid secondhand exposure to the greatest extent
possible."
SOURCE: http://bit.ly/1sh3Ya8 Tobacco Control, online April 26,
2016.
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