Most clinicians fail to counsel pregnant patients about smoking risks

LAS VEGAS – Although data have shown that health care providers can have a positive influence on patient knowledge about the negative effects of smoking during pregnancy, many clinicians are not counseling their male and female patients about these risks, research presented during a poster presentation at the 39th American Academy of Physician Assistants Annual Meeting indicate.

For the past 20 years, the health care community has known that maternal smoking during pregnancy (MSDP) is associated with premature birth, low birth weight, stillbirth, spontaneous abortion, and sudden infant death syndrome (SIDS).

Babies born to mothers who smoke also have higher rates of asthma, bronchitis, pneumonia, and otitis media. Despite this knowledge, 12% to 20% of women who smoke do not cease smoking during pregnancy.

Researchers from Le Moyne College in Syracuse, New York, assessed the extent of both men's and women's knowledge of the effects of maternal smoking during pregnancy as well as the sources of this information.

The researchers surveyed 423 male and female attendees at the 2010 New York State Fair at a health information booth sponsored by the New York State Society of Physician Assistants (NYSSPA).

They found that only 28.6% of the participants had been educated about the risks of maternal smoking during pregnancy by a health care provider. On average, patients who had been educated by a clinician answered more questions correctly than those who were not (P<0.001).

Health care provider had a greater impact on male patient attitudes than female patient attitudes (P=.004), data indicated. The number of correct responses also correlated with education level (P<0.001) and smoking status (P =.023). While most participants knew about the potential effects of asthma, low birth weight  and bronchitis, most did not know that maternal smoking can result in stillbirth, SIDS and low IQ. Specifically, less than 50% of respondents identified SIDS as a risk of MSDP.

“While the assumption cannot be made that increased knowledge correlates with decreased smoking during pregnancy, it is important that physician assistants counsel females and males alike regarding the dangers of MSDP,” the researchers wrote. “Counseling provided by PAs should include information about the mortal dangers of smoking during pregnancy that seem to be less well-known to the general public, such as SIDS and stillbirth.”

Brown A, Hoyos A, Mahar E, et al. "Relationship between patient education and patients' knowledge about the dangers of maternal smoking during pregnancy." Presented at: American Academy of Physician Assistants' 39th Annual PA Conference. 2011: Las Vegas, Nevada. 
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