Smoking During Pregnancy. At any time (%): Equity Aboriginal women Decrease from previous year Increase on previous year No change Decrease from previous year Equity Non-aboriginal women Decrease from previous year Increase on previous year No change Decrease from previous year Effectiveness Pregnant Women Quitting Smoking - By second half of pregnancy (%) 4% increase on previous year <1% increase on previous year ≥1% and <4% increase on previous year 4% increase on previous year 1.4 Population Health Human Immunodeficiency Virus (HIV) Testing - Within publicly-funded HIV and sexual health services: Variance (%) Individual - See Data Supplement <98 Target >=98 and <100 >=100 Effectiveness Hepatitis C Antiviral Treatment Initiation – Direct acting - by LHD residents: Variance (%) Individual - See Data Supplement <98 Target >=98 and <100 >=100 Strategy 2: Provide World-Class Clinical Care Where Patient Safety is First 2.1 Safety Fall-related Injuries in Hospital – Resulting in fracture or intracranial injury – Rate (per 1,000 bed days) <0.12 >=0.15 >=0.12 and <0.15 <0.12 Safety 3rd or 4th Degree Perineal Lacerations During Delivery (Rate per 1,000 bed days) <0.28 >=0.39 >=0.28 and <0.39 <0.28 Safety Hospital Acquired Venous Thromboembolism (Rate per 1,000 bed days) <0.21 >=0.30 >=0.21 and <0.30 <0.21 Safety Hospital Acquired Pressure Injuries (Rate per 1,000 bed days) <0.27 >=0.44 >=0.27 and <0.44 <0.27 Safety Healthcare Associated Infections (per 1,000 bed days) <2.64 >=2.99 >=2.64 and <2.99 <2.64 Safety Surgical Complications Requiring Unplanned Return to Theatre (Rate per 1,000 bed days) <0.45 >=0.56 >=0.45 and <0.56 <0.45 Safety Hospital Acquired Medication Complications (Rate per 1,000 bed days) <0.75 >=1.00 >=0.75 and <1.00 <0.75
Smoking During Pregnancy. Prevalence and measurement Smoking during pregnancy is associated with a few adverse birth outcomes, such as miscarriage, low birth weight, premature birth, congenital birth defects, and Sudden Infant Death Syndrome (47). As a result, the CDC recommends women who are pregnant or who are trying to become pregnant to quit smoking (44, 47). In addition, pregnant women should also avoid e- cigarettes and secondhand smoke throughout the duration of her pregnancy (47). Measuring smoking during pregnancy accurately can be very difficult, as smoking is often self-reported. Measures of the overall prevalence of smoking during pregnancy are often subject to social desirability bias, as women may under report their smoking during pregnancy (7). Cotinine, a primary metabolite of nicotine, can be measured in women’s blood plasma to avoid the social desirability bias that is often present in studies that require women to self-report their smoking status (4, 18). One study conducted by Xxxxxxxxx et al. quantified the discrepancies between self-reported smoking status and smoking status as determined by plasma cotinine levels. The researchers found that 1.4% of those who reported themselves as non-smokers had plasma cotinine levels that indicated the respondents were current smokers. These discrepancies were higher in respondents who were over the age 65, had 0-8 years of education, and who were black (4). The American College of Obstetricians and Gynecologists reported that the rate of overall reported smoking during pregnancy among women in the U.S. was 13.2% in 2006 (44). Adverse health outcomes for smoking during pregnancy There are a number of adverse birth outcomes associated with smoking during pregnancy. One study that investigated the effect of smoking during pregnancy among pregnant women in Romania found a significant association between smoking and low birth weight. The researchers also found that women who smoked more cigarettes during their pregnancy had a higher risk of giving birth to a low birth weight infant than women who smoked fewer cigarettes. Women who continued to smoke throughout their pregnancies were also at an increased risk for having a small for gestational age infant. Women who quit smoking early in their pregnancy had risks of adverse birth outcomes similar to women who did not smoke, demonstrating the importance of quitting cessation during pregnancy (29). In addition to low birth weight and small gestational age infants, smoking during pr...
