The effect of maternal cigarette smoking on low birth weight and preterm birth in Wisconsin, 1991.

Cigarette smoking is one of the most preventable causes of low birth weight in the United States. This paper presents new data on the relationship between low birth weight and maternal cigarette smoking in Wisconsin based on an analysis of 1991 birth certificates. In Wisconsin in 1991, 22.5% of mothers reported smoking cigarettes during pregnancy. Mothers who smoked cigarettes were twice as likely to bear low birth weight infants as were non-smokers. Low birth weight accounted for 49% of newborn hospital charges totaling $60.7 million. A 50% reduction in maternal smoking could potentially save $5 million in newborn hospital costs. A women is more likely to quit smoking during pregnancy. Physicians are in a unique position to encourage positive behavior change that will reduce the risk for low birth weight and have long term benefits for her and her family.

Alcohol use during pregnancy: implications for physicians.

There has been concern since antiquity that the ingestion of alcohol by the pregnant woman could damage the fetus, but it was not until 1973 that the fetal alcohol syndrome was first described. The broad effect of alcohol-related birth defects, including fetal alcohol effects (FAE), has become apparent even more recently. Physicians can play a central role in the prevention of alcohol-related birth defects through early detection, education of the mother, and appropriate referrals. This paper reviews the effects of maternal alcohol use on the fetus, discusses the importance of assessing alcohol use among all women of child bearing age, and examines intervention strategies that physicians can use to help pregnant women stop or reduce alcohol use. Funding for this paper was provided by the Maternal and Child Health Block Grant.