Title: 0329 - Implications of Perinatal Smoking Trajectories in Appalachia in the USA


Linda Alexander (Presenter)
West Virginia University

Daniel McNeil, West Virginia University
Matthew Arias, West Virginia University
Casey Wright, West Virginia University
Elizabeth Kao, West Virginia University
Katherine Neiswanger, University of Pittsburgh
Robert Weyant, University of Pittsburgh
Betsy Foxman, University of Michigan
Richard Crout, West Virginia University School of Dentistry
Mary Marazita, University of Pittsburgh


Objectives: Appalachia has poorer health status—including higher tobacco use—than many other areas of the USA. Many women in Appalachia and elsewhere reduce or eliminate tobacco use during pregnancy and the postpartum period, but a subset continue use during pregnancy or return to it immediately after the birth of their child. We explored the associations of smoking trajectories with oral and mental health among perinatal women in Appalachia.

Methods: Women participating in the Center for Oral Health Research in Appalachia longitudinal cohort study were categorized in terms of three previously-identified smoking trajectories: “non-smoking” (n=838, 77.0%, did not smoke during pregnancy nor postpartum), “rebound” (n=112, 10.3%, abstained from smoking during pregnancy but reinstituted it postpartum), and “amplified” (n=138, 12.7%, smoked during pregnancy and increased their rate postpartum). Measures of oral health (i.e., DMFT, Oral Rating Index) and emotional distress (i.e., Perceived Stress Scale, Center for Epidemiological Studies Depression Scale) were assessed during pregnancy, 10 weeks postpartum, and at 6, 12, 18, and 24 months after birth. We compared associations of smoking trajectories and health outcomes using analyses of variance.

Results: Across both oral health and mental health indicators, being in the amplified smoking group was associated with more oral disease, poorer gingival status, greater stress, and more depression (p < .05). The non-smoking group was consistently associated with better health outcomes; the rebound group was in between.

Conclusions: Smoking during pregnancy and increasing the rate postpartum was associated with poorer maternal oral health and mental health outcomes, although any tobacco use was associated with poorer health indicators generally. Stress and depression may be targets for intervention in women who use tobacco in Appalachia.

This abstract is based on research that was funded entirely or partially by an outside source:
National Institute of Dental and Craniofacial Research R01-DE014899

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE