Smoking during pregnancy puts baby’s life at risk

Press, 3 December 1982, Page 7

Smoking during pregnancy puts baby’s life at risk

Women who smoke during pregnancy increase the risk of their baby dying before it is a year old, according to a national survey of post-neo-natal mortality made by the Health Department in' 1978 and 1979, and released recently. The 1 survey studied the family histories of 316 infants aged between one month and one year (postneonatal), who died between March 1, 1978 and February 28, 1979. Departmental medical officers studied hospital notes and interviewed the parents of each child. . Infants most at risk of dying in the post-neonatal period are those born to Maori mothers, those of low birth-weight, and infants born to women under 25 years, the survey said. The survey was commissioned after’ it was discovered that more babies aged one month or more died in New Zealand in 1979 than in any other Western country. In New Zealand, 6.1 babies in 1000 died in 1979, and the year before, the figure was 6.4 per 1000 live births. Australia, the United States, and most European countries including England, had a comparable mortality rate of less than 5 per 1000 live births. Although the average infant death rate for New Zealand was six babies in every 1000 born alive, the comparable rate for babies

born to Maori mothers was exactly double — 12 per 1000 live births. Maori mothers under 25 had an even higher infant mortality rate, of 14 per 1000 live births. Young Maori mothers were also more likely to smoke cigarettes during their pregnancy, the survey said. About 85 per cent of Maori women under the age of 25 smoked regularly throughout their pregnancy. About 57 per cent of non-Maori women of the same age smoked regularly throughout their pregnancy. The survey also revealed a large difference in the age of pregnant women who smoked. Under 25 years. 66 per cent of the mothers smoked, while only 39 per cent of mothers older than 25 smoked. The national average for women who smoke cigarettes is 35 per cent. 01 the mothers who were surveyed after their babies had died, 53 per cent admitted smoking regularly, including during their pregnancy. The most likely conclusion of these statistics was that regular maternal smoking resulted in increased infant deaths. A British survey in 1970 confirmed this. It showed that women who smoked during pregnancy were 56 per cent more likely to have their baby die in its first year than women who did hot smoke. The Health Department survey acknowledged that

research throughout the world had already shown that cigarette ’ smoking adversely affected the unborn foetus and the newborn baby, and that ’many babies born to mothers who had smoked during pregnancy were underweight. Analyis of birthweights in the survey showed that Maori mothers under the age of 30 had the highest rate of underweight babies (weighing less than 2500 g at birth). About 30 in every 1000 Maori babies was shown to have been underweight and had since died, whereas the comparable rate for nonMaori babies under 30 was half that number. The survey also showed that Maori women and women under 25 whose babies had died did not attend as many ante-natal classes as older women. "This may be another factor influencing the high proportion of low birthweight infants born to younger mothers.” the survey’ said. "Mothers receiving regular ante-natal care are advised of the risks of smoking and the value of good nutrition, as well as receiving continued attention, which would detect complications of pregnancy at an early age." it said. "If any of these things are neglected. the baby’s birthweight could be affected." The survey said that the high post-neonatal mortality rate of low birthweight infants was an important contributor to New Zealand's

high infant mortality ' rate, but it is apparent that other factors, were also important. “If the deaths of low birthweight infants, and the deaths due to accidents and violence were eliminated. New Zealand would still have a rate more than twice as high as Sweden’s, but at least more comparable with Australia. England and the United States." the survey said. Accidents and violence accounted for 17 of the 316 infant deaths surveyed. The greatest cause of death (about half the infant deaths in one year) was Sudden Infant Death Syndrome (known as cot death). Other more common causes of infant death were acute infectious respiratory diseases, and congenital anomalies. Combined with cot deaths, they made up 73 per cent of all infant deaths. The Maori death-rate from intestinal infectious diseases was nine times higher than for non-Maori infants; for accidents and violence, it was seven times higher; for other infectious and parasitic diseases it was three times higher; and the rate of cot deaths was twice as high. The survey said that the review committee which investigated each death had concluded that 9 per cent of the infant deaths were preventable. 12 per cent were possibly preventable, and 79 per cent were not.