SMOKING PREVALENCE DURING PREGNANCY FOR WOMEN WHO ARE AND WOMEN WHO ARE NOT MEDICAID-FUNDED

Maternal smoking has been related to a number of adverse pregnancy out comes. Although maternal smoking prevalence has decreased over time, c ertain populations have retained a high smoking prevalence and remain at high risk for adverse pregnancy outcomes. This study used the Washi ngton State First Steps Program Database to estimate the difference in maternal smoking prevalence between mothers whose prenatal or deliver y care was Medicaid-funded and mothers whose care was not Medicaid-fun ded. We evaluated differences in maternal smoking prevalence between t hese two groups by marital status, race, adequacy of prenatal care, an d age. Among the Medicaid-funded mothers, the age-adjusted maternal sm oking prevalence was 44.4% versus 16.3% for those not Medicaid-funded. Among married Medicaid-funded mothers, the smoking prevalence was 2.6 times higher in whites, 1.4 times higher in blacks, and 1.8 times hig her in American Indians than for married mothers not funded by Medicai d. Among single Medicaid-funded mothers, the rate was 1.4 times higher in whites and 1.7 times higher in blacks. Differences in smoking prev alence were most apparent among older mothers. For single white and si ngle black mothers, the smoking prevalence increased with increasing m aternal age among both Medicaid-funded and other women. Adequacy of pr enatal care also influences smoking prevalence. For white and black mo thers, the maternal smoking prevalence was lower for those receiving a dequate prenatal care than for mothers of the same race who received i nadequate prenatal care. The increased maternal smoking prevalence in older single mothers and the higher maternal smoking prevalence in wom en with Medicaid-funded deliveries suggest that infants born to these mothers may be particularly susceptible to smoking-related health effe cts.