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Depressive Symptoms and Smoking During Pregnancy
Despite a cessation program, pregnant women with depressive symptoms found it difficult to quit.
Smoking during pregnancy increases risks for outcomes ranging from preterm birth to sudden infant death syndrome. Reducing or quitting smoking during pregnancy decreases these risks. In cross-sectional studies, depressive symptoms have been associated with continued smoking during pregnancy, as well as with lower rates of smoking cessation in the general population.
To learn more, researchers reanalyzed longitudinal data from a study on a low-intensity smoking cessation program for pregnant women. The study excluded women with current DSM-IV major depression (31% of those screened). Of 81 participants, 26 (32%) had current dysthymia, major depression in partial remission, or minor depression. Participants set a quit date within 2 weeks and were mailed a self-help quit calendar and cessation guide, either alone or with six videotapes on smoking cessation and relapse prevention. Participants self-reported their smoking at 2 and 30 days after the quit date and at 30 days postpartum.
Abstinence rates were low overall, with a trend toward lower abstinence rates in women with a current depressive disorder than in those without one, at 30 days post-quit (4% vs. 13%) and at 30 days postpartum (0% vs. 6%). Surprisingly, women with dysthymia significantly increased smoking from 2 days post-quit to 30 days post-quit, whereas women with no disorder showed little change. At 30 days post-quit, women with dysthymia smoked significantly more than women without a depression disorder.
Comment: Although limited by small sample size, reliance on self-report, and exclusion of women with current major depression, this study documents associations between other current disorders and lower abstinence rates, and between dysthymia and increased smoking. These observations add to concerns about the effects of untreated depression on smoking during pregnancy and thus on infant morbidity and mortality.
— Deborah Cowley, MD
Published in Journal Watch Psychiatry September 18, 2006
Citation(s):
Blalock JA et al. Relationship of DSM-IV-based depressive disorders to smoking cessation and smoking reduction in pregnant smokers. Am J Addict 2006 Jul/Aug; 15:268-77.
- Medline abstract (Free)