@Article{info:doi/10.2196/29718,
author="Hu, Kadi
and Zou, Shiqian
and Zhang, Casper JP
and Wu, Huailiang
and Akinwunmi, Babatunde
and Wang, Zilian
and Ming, Wai-Kit",
title="Health-Related Quality of Life Among Pregnant Women With Pre-pregnancy Smoking and Smoking Cessation During Pregnancy in China: National Cross-sectional Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Jan",
day="24",
volume="8",
number="1",
pages="e29718",
keywords="health-related quality of life; pregnant women; smoking status; pre-pregnancy smoking",
abstract="Background: Previous studies have hardly explored the influence of pre-pregnancy smoking and smoking cessation during pregnancy on the health-related quality of life (HRQoL) of pregnant women, which is a topic that need to be addressed. In addition, pregnant women in China constitute a big population in the largest developing country of the world and cannot be neglected. Objective: This study aims to evaluate the HRQoL of pregnant women in China with different smoking statuses and further estimate the association between pre-pregnancy smoking, smoking cessation, and the HRQoL. Methods: A nationwide cross-sectional study was conducted to determine the association between different smoking statuses (smoking currently, quit smoking, never smoking) and the HRQoL in pregnant women across mainland China. A web-based questionnaire was delivered through the Banmi Online Maternity School platform, including questions about demographics, smoking status, and the HRQoL. EuroQoL Group's 5-dimension 5-level (EQ-5D-5L) scale with EuroQoL Group's visual analog scale (EQ-VAS) was used for measuring the HRQoL. Ethical approval was granted by the institutional review board of the First Affiliated Hospital of Sun Yat-sen University (ICE-2017-296). Results: From August to September 2019, a total of 16,483 participants from 31 provinces were included, of which 93 (0.56{\%}) were smokers, 731 (4.43{\%}) were ex-smokers, and 15,659 (95{\%}) were nonsmokers. Nonsmokers had the highest EQ-VAS score (mean 84.49, SD 14.84), smokers had the lowest EQ-VAS score (mean 77.38, SD 21.99), and the EQ-VAS score for ex-smokers was in between (mean 81.04, SD 17.68). A significant difference in EQ-VAS scores was detected between nonsmokers and ex-smokers (P<.001), which indicated that pre-pregnancy smoking does have a negative impact on the HRQoL (EQ-VAS) of pregnant women. Compared with nonsmokers, ex-smokers suffered from more anxiety/depression problems (P=.001, odds ratio [OR] 1.29, 95{\%} CI 1.12-1.50). Among ex-smokers, the increased cigarette consumption was associated with a lower EQ-5D index (P=.007) and EQ-VAS score (P=.01) of pregnant women. Compared to smokers, no significant difference was found in the ex-smokers' EQ-5D index and EQ-VAS score (P=.33). Conclusions: Smoking history is associated with a lower HRQoL in pregnant Chinese women. Pre-pregnancy smoking is related to a lower HRQoL (EQ-VAS) and a higher incidence of depression/anxiety problems. Smoking cessation during pregnancy does not significantly improve the HRQoL of pregnant Chinese women. Among ex-smokers, the more cigarettes they smoke, the lower HRQoL they have during pregnancy. We suggest that the Chinese government should strengthen the education on quitting smoking and avoiding second-hand smoke for women who have pregnancy plans and their family members. ",
issn="2369-2960",
doi="10.2196/29718",
url="https://publichealth.jmir.org/2022/1/e29718",
url="https://doi.org/10.2196/29718",
url="http://www.ncbi.nlm.nih.gov/pubmed/35072649"
}