Smoking ban and small-for-gestational age births in Ireland

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dc.contributor.author Kabir, Zubair
dc.contributor.author Daly, Sean
dc.contributor.author Clarke, Vanessa
dc.contributor.author Keogan, Sheila
dc.contributor.author Clancy, Luke
dc.date.accessioned 2016-02-17T11:46:19Z
dc.date.available 2016-02-17T11:46:19Z
dc.date.issued 2013
dc.identifier.citation Kabir Z, Daly S, Clarke V, Keogan S, Clancy L (2013) Smoking Ban and Small-For-Gestational Age Births in Ireland. PLoS ONE 8(3): e57441. doi:10.1371/journal.pone.0057441 en
dc.identifier.volume 8 en
dc.identifier.issued 3 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/2387
dc.identifier.doi 10.1371/journal.pone.0057441
dc.description.abstract Background: Ireland introduced a comprehensive workplace smoke-free legislation in March, 2004. Smoking-related adverse birth outcomes have both health care and societal cost implications. The main aim of this study was to determine the impact of the Irish smoke-free legislation on small-for-gestationa-age (SGA) births. Methods and Findings: We developed a population-based birthweight (BW) percentile curve based on a recent study to compute SGA (BW < 5th percentile) and very SGA (vSGA-BW < 3rd percentile) for each gestational week. Monthly births born between January 1999 and December 2008 were analyzed linking with monthly maternal smoking rates from a large referral maternity university hospital. We ran individual control and CUSUM charts, with bootstrap simulations, to pinpoint the breakpoint for the impact of ban implementation (=April 2004). Monthly SGA rates (%) before and after April 2004 was considered pre and post ban period births, respectively. Autocorrelation was tested using Durbin Watson (DW) statistic. Mixed models using a random intercept and a fixed effect were employed using SAS (v 9.2). A total of 588,997 singleton live-births born between January 1999 and December 2008 were analyzed. vSGA and SGA monthly rates declined from an average of 4.7% to 4.3% and from 6.9% to 6.6% before and after April 2004, respectively. No auto-correlation was detected (DW =similar to 2). Adjusted mixed models indicated a significant decline in both vSGA and SGA rates immediately after the ban [(-5.3%; 95% CI -5.43% to -5.17%, p < 0.0001) and (-0.45%; 95% CI: -0.7% to -0.19%, p < 0.0007)], respectively. Significant gradual effects continued post the ban periods for vSGA and SGA rates, namely, -0.6% (p < 0.0001) and -0.02% (p < 0.0001), respectively. Conclusions: A significant reduction in small-for-gestational birth rates both immediately and sustained over the post-ban period, reinforces the mounting evidence of the positive health effect of a successful comprehensive smoke-free legislation in a vulnerable population group as pregnant women. en
dc.description.sponsorship Health Research Board of Ireland (PD/2009/34) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights © 2013 Kabir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Maternal smoking en
dc.subject Preterm birth en
dc.subject Weight en
dc.subject Exposure en
dc.subject Fetal en
dc.subject Outcomes en
dc.subject Growth en
dc.subject Risk en
dc.subject Legislation en
dc.subject Workers en
dc.title Smoking ban and small-for-gestational age births in Ireland en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Zubair Kabir, Epidemiology & Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: z.kabir@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.internal.wokid WOS:000317418500004
dc.contributor.funder Health Research Board en
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress z.kabir@ucc.ie en
dc.identifier.articleid e57441


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© 2013 Kabir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Except where otherwise noted, this item's license is described as © 2013 Kabir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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