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80 The cost of smoking in pregnancy - A retrospective study

      Introduction and study aims: The UK Department of Health aims to reduce smoking at time of delivery (SATOD) to below 6% by 2022. Sherwood Forest Hospital NHS Foundation Trust (SFHFT) had a SATOD of 16.5% in 2019-2020. The aim was to demonstrate how smoking continues to affect patients, to motivate and engage staff in smoking cessation strategies. Methods: Retrospective study of 25 non-smokers’ and 25 smokers’ who had delivered at SFHFT in the first quarter of 2020, comparing antenatal contacts and pregnancy-related complications. Inclusion criteria were maternal age (18 - 40 years) and BMI (18 - 25). Data was collected from Orion (electronic maternity pathway). The two groups were then compared using the Mann-Whitney U test. Results: The smoking group were 9 times less likely to attend appointments and had an average of 5.28 growth scans (compared to non-smokers 0.96 scans). They were 3 times more likely to have an antenatal complication - small for gestation age (SGA) [RR 9], fetal growth restriction (FGR) [RR 10], low Papp-A, antepartum haemorrhage, preterm birth, oligohydramnios and reduced fetal movements. Smokers were more likely to be induced for SGA/FGR (RR 5.5), have a baby below the 10th centile (RR3) and develop intrapartum complications (RR 1.45). Smokers were 3.6 times less likely to breast feed. All findings were clinically significant (p≤0.05). The cost of continued smoking in pregnancy for SFHFT is £1,731,560 per year. Conclusion: Despite increased surveillance in SATOD pregnancies, the short and long term consequences for these women and their babies are significant. It has previously been demonstrated that babies born with low birth weights are at increased risk of adult diseases, hence the true financial burden is therefore far greater and the continued need to decrease SATOD is clear.
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