The effect of quitting water pipe during pregnancy on Anthropometric measurements at birth: a population-based prospective cohort study in South of Iran

Abstract Background: Evidence regarding health effects of tobacco cessation during pregnancy is mainly restricted to cigarette while water pipe is the preferred method of tobacco smoking among women in the Middle-East. The present ‎study aimed to assess the effects of cessation of water pipe during pregnancy on ‎birth anthropometric measures in the south of Iran.Methods: Data on 1,120 singleton pregnancies (response rate=93.4%) from a population-based prospective cohort study in suburban communities in Bandar Abbas city was used. Based on water pipe ‎smoking status, the study subjects were categorized into: 1) those who never smoke water pipe ‎‎(never smoker); 2)those who stopped water pipe during pregnancy and resumed it postpartum (quitters); 3) those who continued smoking water pipe during their pregnancy (always smokers). The ‎Generalized Linear Models (GLMs) were utilized for the analyses.Results: Compared to never smokers, quitting water pipe in pregnancy decreased mean birthweight of infants by 99.30 ‎grams (β:-99.30, 95%CI:-204.35,-5.75‎) and an additional decrease of 37.83 grams occurred in infants of always smokers (β:-137.13‎;95%CI:-262.21,-‎‎12.05‎). Means of birth length ‎did not significantly differ among the three water pipe groups. Means of head ‎circumference, however, significantly increased by 0.79 centimeter in infants of always smokers (β:079,95%CI:0.13,1.45). ‎Conclusion: Quitting water pipe during pregnancy had positive effects on infant growth, especially birth weight. Awareness campaigns about health benefits of quitting water pipe during routine prenatal checkups and integration of active follow-up visits into prenatal care protocols for smoking mothers are provided.