Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms.

dc.contributor.author

Schechter, Julia

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Do, Elizabeth K

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Zhang, Junfeng Jim

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Hoyo, Cathrine

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Murphy, Susan K

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Kollins, Scott H

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Fuemmeler, Bernard

dc.date.accessioned

2019-02-24T19:01:01Z

dc.date.available

2019-02-24T19:01:01Z

dc.date.issued

2018-12-24

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2019-02-24T19:00:59Z

dc.description.abstract

Introduction:Both prenatal smoke exposure and depression have been linked to lower birth weight, a risk factor for morbidity and mortality. Few studies have looked at the interaction between these risk factors and none have used a biomarker to objectively measure prenatal smoke exposure. The current study sought to examine independent and interactive effects of cotinine and depression on birth weight. The effect of race was also explored. Method:Data were drawn from a prospective study of pregnant women (N=568) in the southeastern U.S. Maternal demographic, health information, depressive symptoms, and birth data were collected via self-report and medical record abstraction. Prenatal blood samples were assayed for cotinine. Results:Controlling for covariates, multiple regression analyses indicated that both cotinine and depressive symptoms independently predicted lower birth weight and a significant interaction was also observed. Upon probing the interaction, a negative association between cotinine levels and birth weight was found in the context of higher depression but not lower depression scores. Similarly, logistic regression analyses revealed a significant interaction between cotinine and depression, such that cotinine predicted having a baby < 2500 g among women who fell above the indicated cut-off score. African American women had the highest levels of cotinine and lowest weight babies; however, race was not a significant moderator. Conclusions:Results suggest prenatal smoke exposure has a greater negative effect on birth weight for women endorsing co-occurring depressive symptoms. Findings can inform targeted interventions and assist medical providers with identifying women at increased risk for poor perinatal outcomes. Implications:Despite the common occurrence of smoking during pregnancy and prenatal depression, the interaction between these risk factors on birth weight has rarely been examined. Further, the extant results have been mixed, likely due in part to difficulties in measurement. The current study was the first to use prenatal cotinine to assess bias-free, continuous levels of prenatal smoke exposure. Results indicate that prenatal cotinine was a significant predictor of birth weight only in the context of maternal depressive symptoms. These findings have important implications for mitigating negative perinatal outcomes for pregnant women and their children.

dc.identifier

5258109

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1462-2203

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1469-994X

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https://hdl.handle.net/10161/18071

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eng

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Oxford University Press (OUP)

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Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

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10.1093/ntr/nty267

dc.title

Effect of Prenatal Smoke Exposure on Birth Weight: The Moderating Role of Maternal Depressive Symptoms.

dc.type

Journal article

duke.contributor.orcid

Zhang, Junfeng Jim|0000-0003-3759-6672

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Murphy, Susan K|0000-0001-8298-7272

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Kollins, Scott H|0000-0001-6847-6935

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School of Medicine

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Duke

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Psychology and Neuroscience

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Trinity College of Arts & Sciences

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Center for Child and Family Policy

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Sanford School of Public Policy

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Duke Cancer Institute

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Institutes and Centers

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Duke Clinical Research Institute

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Duke Institute for Brain Sciences

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University Institutes and Centers

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Institutes and Provost's Academic Units

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Psychiatry & Behavioral Sciences, Addictions

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Psychiatry & Behavioral Sciences

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Clinical Science Departments

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Environmental Sciences and Policy

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Nicholas School of the Environment

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Pathology

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Psychiatry, Child & Family Mental Health and Developmental Neuroscience

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