Tobacco use in pregnant women: Analysis of data from Demographic and Health Surveys from 54 low-income and middle-income countries

Background Worldwide, use of tobacco is viewed as an important threat to the health of pregnant women and their children. However, the extent of tobacco use in pregnant women in low-income and middle-income countries (LMICs) remains unclear. We assessed the magnitude of tobacco use in pregnant women in LMICs. Methods We used data from Demographic and Health Surveys (DHS) done in 54 LMICs between Jan 1, 2001, and Dec 1, 2012, comprising 58 922 pregnant women (aged 15-49 years), which were grouped by WHO region. Prevalence of current tobacco use (smoked and smokeless) was estimated for every country. Pooled estimates by regions and overall were obtained from random-eff ects meta-analysis. Findings Pooled prevalence of any tobacco use in pregnant women in LMICs was 2·6% (95% CI 1·8-3·6); the lowest prevalence was in the African region (2·0%, 1·2-2·9) and the highest was in the Southeast Asian region (5·1%, 1·3-10·9). The pooled prevalence of current tobacco smoking in pregnant women ranged from 0·6% (0·3-0·8) in the African region to 3·5% (1·5-12·1) in the Western Pacific region. The pooled prevalence of current smokeless tobacco use in pregnant women was lowest in the European region (0·1%, 0·0-0·3) and highest in the Southeast Asian region (2·6%, 0·0-7·6). Interpretation Overall, tobacco use in pregnant women in LMICs was low; however high prevalence estimates were noted in some LMICs. Prevention and management of tobacco use and exposure to second-hand smoke in pregnancy is crucial to protect maternal and child health in LMICs.