Introduction: This report examined pregnant smokers and nonsmokers to develop a better understanding of factors that contribute to variations in prenatal health-related behaviors.
Methods: Data were obtained from 913 women in a prospective, longitudinal adoption study who reported approximately 3 months postpartum on pregnancy smoking, prenatal vitamin (PNV) use, antisocial behaviors, depression and anxiety symptoms, and attendance at prenatal visits.
Results: 40% of participants reported smoking during pregnancy, and 24% reported smoking more than 6 cigarettes per day for one or more trimesters. On average women attended 10.2 prenatal visits and took PNVs 1–2 times per week. Pregnancy smoking was correlated with poorer adherence to PNVs, though the relationship with number of prenatal visits was not significant after controlling for timing of pregnancy recognition. Maternal antisocial behavior was correlated with both cigarette smoking (any smoking r = .19, p < .01; heavy smoking r = .18, p < .01), and inversely with frequency of PNV intake (r = −.17, p < .01). A trend toward partial mediation by maternal antisocial behavior in the relationship between cigarette smoking and poor adherence to PNVs, controlling for maternal age, depressive symptoms, and adequacy of prenatal care, was detected, F(5,363) = 7.55, p < .0001; adjusted R2 = .08; CI (−.14, −.03).
Conclusions: In this study we found an association between prenatal smoking and poor adherence to PNV intake. Maternal antisocial behaviors during pregnancy appeared to be a marker for poor adherence to recommendations for dietary supplementation among pregnant smokers, independent of adequacy of prenatal care.