Date of Award


Document Type

Open Access Thesis


Epidemiology and Biostatistics



First Advisor

Jihong Liu


Purpose: To determine if smoking cessation during pregnancy is associated with excessive gestational weight gain (GWG).

Methods: Data came from the 2009-2011 Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing population-based survey of live births in South Carolina (n=2,603). Participant smoking status was classified as nonsmoker (did not smoke before or during pregnancy), persistent smoker (smoked before and throughout pregnancy), or quitter (smoked before but quit during pregnancy). Multinomial logistic regression model was estimated to examine the association between smoking status and meeting the 2009 Institute of Medicine guidelines, while linear regression model was used for the continuous outcomes such as the rate of weight gain in the 2nd and 3rd trimesters and total GWG (full term births only).

Results: Over half (51.2%) of South Carolinian mothers had excessive GWG during pregnancy with an additional quarter of women gaining weight below (24.4%) or within (24.4%) the guidelines. The mean total weight gain was 28.5 lbs (±0.55). Regarding smoking status, about 69.5% were non-smokers, 14.5% were persistent smokers, and 16% were quitters. After adjusting for potential confounders, nonsmokers had a significantly lower weekly rate of weight gain in the 2nd and 3rd trimesters (-0.23 lb) and gained about 6 lbs less than quitters. The weight gain experiences were similar between persistent smokers and quitters. Smoking status was not associated with meeting IOM guidelines.

Conclusions: Higher GWG among quitters than non-smokers suggests a need for smoking cessation programs to promote healthy GWG, perhaps through counseling on healthy eating and active living.


© 2015, LaQuenta Latreese Weldon

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