Adolescent Pregnancy and Smoking in West Virginia: Pregnancy Risk Assessment Monitoring System (PRAMS) 2005-2010

Background: Smoking during pregnancy is associated with deleterious pregnancy and infant birth outcomes including small for gestational age and low birth weight. While national prenatal smoking rates have declined, West Virginia remains a state with the highest rate of prenatal smoking in the nation. Smoking rates are even higher among pregnant adolescents in the state.

Objective: The purpose of this study was to examine the association between prenatal smoking and small for gestational age (SGA) infants among adolescent women in West Virginia, taking into account socio-demographic and health-related factors.

Methods: Secondary data analysis was conducted using the 2005-2010 West Virginia Pregnancy Risk Assessment and Monitoring Systems (WV PRAMS) weighted dataset. The study population using complete case analysis procedure consisted of 886 adolescent women ages 19 and younger who delivered a live singleton infant in West Virginia.

Results: The prevalence of smoking among adolescents during the last three months of pregnancy was 67%. Nearly a quarter (22.0%) of the adolescents had small for gestational age (SGA) infants. Results from the logistic regression analysis showed that after controlling for socio-demographic and health-related variables, adolescents who smoked during the last three months of pregnancy were more likely to have SGA infants than those who did not smoke during the last three months of pregnancy (OR=1.86, 95% CI: 1.06-3.27, p=0.0307).

Conclusion: This study highlights the importance of recognizing that prenatal smoking is an issue among West Virginia adolescents and the need for evidence-based, culturally, and developmentally appropriate interventions for this Appalachian population.