Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981-82

Abstract

Analysis of cigarette smoking and alcohol consumption patterns recorded in pregnancy could not detect a harmful effect of alcohol at levels below 2 glasses a day. Total abstainers fared very slightly worse than those who drank occasionally. Smoking was associated with lower birth-weight and a worse fetal outcome independent of socioeconomic status, parity, maternal age or alcohol consumption. There was evidence of an interaction between smoking and adverse social and parity factors in low birth-weight.

PIP: Fetal outcome in all 15,000 births occurring in Tanzania in 1981-82 was analyzed on the basis of alcohol consumption, cigarette smoking, parity, socioeconomic status, and maternal age. Smokers tended to be concentrated in the lower socioeconomic groups, whereas alcohol consumption was more prevalent among women of higher socioeconomic status. The data failed to suggest any harmful effects on the fetus of alcohol consumption at levels below 2 glasses/day. Moreover, the infants of total abstainers were slightly lighter at birth than those of mothers who drank occasionally. On the other hand, infants of mothers who drank 2 or more glasses of alcohol/day were an average of 300 gm smaller than those of abstainers. There was no evidence of an association between congenital malformations and alcohol consumption, even among the heaviest drinkers. In contrast, the relationship between cigarette smoking and low birth weight was significant. The incidence of low birth weight (2.5 kg) deliveries increased from 3.3% among nonsmokers to 5.7% among light smokers to 8.1% among moderate smokers and to 10% among heavy smokers. Controlling for parity, socioeconomic status, gestational age at delivery, and alcohol consumption failed to eliminate the 200 gm birth weight difference between infants of smokers and nonsmokers. However, there was evidence of an interaction between smoking and adverse social and parity factors in low birth weight. Considering problems encountered in convincing women to give up smoking during pregnancy, it is recommended that preventive campaigns be directed at women of childbearing age who have not yet taken up the habit.