Thomas M. Brady, PhD, Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Building, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049, tbrady@samhsa.gov

Research has not adequately examined the role of race/ethnicity in the etiology of placental abruption and placenta previa, which are important causes of maternal and perinatal morbidity. Maternal cigarette smoking is an established risk factor for these complications. What is less clear is the degree to which race/ethnic subpopulation groups play in the development of these complications. Methods: This study used birth certificate data from the NCHS 2000 Natality Data Set. Of the 4.059 million birth records in the year 2000 file, 2.0 million records were randomly selected. Data were chosen from ten states that capture data on tobacco use and utilize 14 racial/ethnic categories, creating a dataset of 631,287 birth records for analysis. A multivariate logistic regression model was employed to measure the association of maternal smoking, race and ethnicity with placental abruption and previa. The model controlled for age, education, gravidity, multiple births, marital status, anemia, hypertension, prenatal care and history of C-section. Results: Smoking and placental disorders varied widely by race and ethnicity. American Indian, Samoan, Hawaiian and White mothers had the highest rates of tobacco use during pregnancy. Maternal smoking was significantly associated with placental abruption and placenta previa. African American and American Indian women were at elevated risk for placental abruption while Filipino, Asian Indian and Korean women were at elevated risk for placenta previa, each with statistical significance. Discussion: In the study of disease etiology, research in maternal and child health should analyze racial and ethnic data and report subpopulation groups where possible.

Learning Objectives:

• 1. Identify at least three race or ethnic groups with above average rates of maternal smoking;
• 2. Recognize at least four risk factors for placental abruption and placenta previa;
• 3. Discuss at least one smoking cessation strategy for primary care settings.

Keywords: Maternal and Child Health, Smoking

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.