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Scottish Smoke-Free Law Cuts Poor Neonatal Outcomes

Introduction of legislation linked to reduction in small for gestational age, preterm delivery

THURSDAY, March 8 (HealthDay News) -- The introduction of smoke-free legislation in Scotland in 2006 has been associated with a reduction in small for gestational age and preterm delivery, according to a study published online March 6 in PLoS Medicine.

To determine the impact of legislation prohibiting smoking in wholly- or partially-enclosed public spaces on preterm delivery and small for gestation age, Daniel F. Mackay, Ph.D., from the University of Glasgow in the United Kingdom, and colleagues conducted analyses using national administrative pregnancy data for Scotland.

The researchers found that the breakpoint of Jan. 1, 2006, produced a better fit than the date of introduction of legislation (March 26, 2006), suggesting an anticipatory effect. The prevalence of current smoking decreased from 25.4 percent before legislation to 18.8 percent after legislation for 716,941 eligible women who conceived between August 1995 and February 2009 and delivered a live-born singleton infant between 24 and 44 weeks of gestation. There were significant reductions in small for gestational age (−4.52 percent), overall preterm delivery (−11.72 percent), and spontaneous preterm labor (−11.35 percent) three months prior to legislation. Significant reductions were seen for current and never smokers.

"In this study, introduction of national, comprehensive smoke-free legislation was associated with significant reductions in preterm delivery and small for gestational age," the authors write. "The results of our study add to the growing evidence of the wide-ranging health benefits of smoke-free legislation and lend support to the adoption of such legislation in countries where it does not currently exist."

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