Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy
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Active and Passive Exposure to Tobacco and e‑Cigarettes During Pregnancy Laura Schilling1,4 · Jacob Spallek2 · Holger Maul3 · Marie Tallarek2 · Sven Schneider4 Accepted: 5 November 2020 © The Author(s) 2020
Abstract Objectives Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-cigarettes among pregnant women. The objective of our current STudy on E-cigarettes and Pregnancy (STEP) was to advance and complement the current knowledge regarding active and passive exposure to tobacco and e-cigarettes before pregnancy and during early and late pregnancy. Methods One element of the STEP study was a quantitative cross-sectional design: A sample of 540 pregnant women recruited at an obstetrician clinic in Hamburg from April 2018 to January 2019 were surveyed once via a standardized questionnaire and provided complete information regarding their consumption of tobacco and e-cigarettes. We performed a descriptive analysis of tobacco and e-cigarette use before pregnancy and during early and late pregnancy, as well as bivariate analysis of these variables with sociodemographic determinants. Passive exposure was assessed by asking the participating pregnant women about the consumption of tobacco and e-cigarettes by their partners, in general, and in their homes. Results Before pregnancy, 20.0% of the participants used tobacco cigarettes exclusively, 1.3% used e-cigarettes exclusively, and 6.5% were dual users. Educational level was significantly associated with tobacco cigarette use (p 17 years, the ability to complete a questionnaire in German, and providing informed consent prior to their inclusion in the study. The STEP participants were surveyed once via a standardized questionnaire, for example, about their use of e-cigarettes before pregnancy and during their early and late pregnancy. The questionnaire was based on an extensive literature review, a previously conducted qualitative study and on items and instruments that were field-tested in other studies. In addition, the questionnaire underwent expert review and was pretested with 10 pregnant women outside the study sample of the Asklepios Klinik Barmbek. The Medical Ethics Committee of the Medical Faculty in Mannheim, Heidelberg University (2017-505 N-MA) provided an initial study approval, which was reviewed and approved by the Ethics Committee of the Hamburg Medical Chamber (MC-178/17). The study was performed in accordance with the ethical standards laid down in the Declaration of Helsinki (1964) and its later amendments. A total of 2092 pregnant women registered for birth during the above-mentioned study period, of which 575 responded to the questionnaire (response rate: 27.5%). The following analysis was based on 540 participants, who provided full information on their consumptio
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