Continued tobacco consumption during pregnancy and women's depression and anxiety symptoms

Objectives This study aimed to analyse depression and anxiety symptoms changes from the first to the third trimester of pregnancy in non-smokers versus quitters versus continuous smokers, and the contribution of depression and anxiety symptoms to continued tobacco consumption during pregnancy. Methods The sample comprises 850 Spanish pregnant women (595 non-smokers, 123 quitters, and 132 continuous smokers), assessed at the first and the third trimester of pregnancy with a questionnaire concerning socio-demographic, obstetric, and tobacco consumption information, and measures of depression and anxiety. Results Continuous smokers during pregnancy showed more depression and anxiety symptoms than both non-smokers and quitters and no changes from the first trimester to the third trimester of pregnancy, while both non-smokers and quitters revealed a decrease in depression and anxiety symptoms. More anxiety symptoms at the first trimester (OR 1.03) and depression symptoms at the third trimester (OR 1.14) were associated with continued smoking during pregnancy. Conclusions Anxiety and depression symptoms need to be considered to screening for women at risk of smoking during pregnancy. Future prenatal smoking cessation interventions must take into account these variables.
We would like to express our gratitude to the midwives at the surveyed Primary Health Care Centers for their valuable assistance. We sincerely appreciate the support by research contract inherent to a predoctoral research training funded by Axudas de Apoio a Etapa Predoctoral do Plan Galego 2011/2015 (Plan 12C) to the second author (Beatriz Pereira). Lastly, we would like to show our gratitude especially to the pregnant women for their patience and generous collaboration in this study.