Tobacco and Anemia- in pregnancy where do we stand?

Abstract The present study aimed to investigate the prevalence and patterns of smokeless tobacco (SLT) use among pregnant women and its association with maternal and neonatal health outcomes. The study included 100 pregnant women, and their SLT use was assessed through self-reporting. The results showed that 40% of women users were aged 18-25 years, another 40% were aged 25-32 years, and 20% were aged 32-39 years. Similar trends were observed in a previous study, which found higher SLT use prevalence among women aged 20-34 years compared to those below 20 years. Among the four main types of SLT used by women (mishri, gutka, mawa, and khaini), mishri alone was preferred by 60% of users, while only 8% exclusively used gutka. Other studies have also reported a high prevalence of mishri use among pregnant women. The present study showed that 32% of women were poly-SLT users, while 68% used only one form of SLT. This finding aligns with previous research that reported a higher proportion of women using only one type of SLT. The study revealed that women used SLT for various reasons, including habit, temptation, morning motions, peer pressure, and family pressure. Similar findings have been reported in previous studies, including SLT's perceived hunger suppression effects and stress reduction beliefs. Some studies have also reported myths related to SLT use, such as improving oral hygiene and preventing teeth weakening during pregnancy.The study found that SLT use during pregnancy was associated with lower hemoglobin levels and a higher prevalence of anemia. Users had a higher incidence of mild, moderate, and severe anemia compared to non-users. This finding is consistent with previous research that linked SLT use to lower hemoglobin levels and an increased risk of anemia. The study also showed a higher percentage of C-section deliveries among SLT users and a higher prevalence of low-birth-weight babies compared to non-users, which aligns with previous findings. Despite being aware of the hazards of SLT consumption, a significant proportion (76%) of users did not intend to change their attitude towards tobacco use during pregnancy. This finding highlights the need for interventions to address SLT use among pregnant women and the importance of providing information on the risks of tobacco use during antenatal care. Finally, the study suggests the need for further research on the adverse pregnancy effects of SLT use and the development of national schemes to address tobacco use during pregnancy.