A study published in the September edition of the Lancet Global Health Journal shows that the Africa Region, has the lowest tobacco use in pregnant women in the world.

Southeast Asia has the highest regional prevalence of tobacco use.

The study which is the largest to provide contemporary evidence on tobacco use during pregnancy using nationally representative samples from 54 Low and Middle Income Countries (LMICs), was conducted during 2001—2012.

According to the study, about one in every 30 pregnant women used tobacco, with wide variations in prevalence within and between World Regions.

While tobacco use in pregnant women in low-income and middle-income countries is low; in Turkey, however, prevalence reaches as high as 15 per cent.

The study which was made available to Ghana News Agency on Monday noted that in 21 of the 54 countries researched, smokeless tobacco was the primary form of tobacco use in pregnant women, thus showing the need to account for these forms of tobacco use in prevention programmes.

The study observed that both smoked and smokeless forms of tobacco encompass a very diverse group of products.

It said smokeless tobacco is often less expensive than manufactured cigarettes and is sometimes viewed by pregnant women as a form of medicine to treat influenza, colds, and other common ailments, as a safer alternative to tobacco smoking, or in some countries is more socially acceptable than tobacco smoking in women.

Pooled prevalence of any tobacco use in pregnant women in LMICs was 2·6 per cent; the lowest prevalence was in the African region 2·0 per cent and the highest was in the Southeast Asian region 5·1 per cent.

The pooled prevalence of current tobacco smoking in pregnant women ranged from 0·6 per cent in the African region to 3·5 per cent in the Western Pacific region.

The pooled prevalence of current smokeless tobacco use in pregnant women was lowest in the European region 0·1 per cent and highest in the Southeast Asian region 2·6 per cent.

It said worldwide, use of tobacco is viewed as an important threat to the health of pregnant women and their children, adding that overall, tobacco use in pregnant women in LMICs was low; however high prevalence estimates were noted in some LMICs.

It said prevention and management of tobacco use and exposure to second-hand smoke in pregnancy is crucial to protect maternal and child health in LMICs.

The study said tobacco is a leading global disease risk factor, although more than 80 per cent of the world's smokers live in low-income and middle-income countries, population-based data for prevalence of tobacco use in pregnant women in these countries is insufficient.

It said the risks associated with tobacco smoking during pregnancy for both mother and child have been established, and include pregnancy complications such as placenta praevia, placental abruption, and pre-eclampsia, and poor fetal outcomes like low birthweight, premature birth, and overall perinatal mortality.

It noted that the use of several forms of smokeless tobacco such as snuff or chewing tobacco, during pregnancy is less studied but has also been associated with stillbirth, preterm birth, and reduced birth weight.

The study said identification of where smoking cessation interventions for pregnant women were most needed in LMICs was particularly important in view of the insufficient antenatal care capacities and poor pregnancy outcomes in many LMICs.

It said because maternal and child health outcomes were often poor in many LMICs, use of tobacco by pregnant women in these settings could substantially worsen outcomes, and therefore slow progress to achieve the Millennium Development Goals 4 (Reduce Child Mortality) and 5 (Improve Maternal Health).

The study said urgent action was needed to prevent and manage tobacco use and second-hand smoke exposure in pregnancy to improve the health of women and children in LMICs at present.