{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:00:52Z","timestamp":1782997252270,"version":"3.54.5"},"reference-count":44,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K99 ES030403"],"award-info":[{"award-number":["K99 ES030403"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01DA048494"],"award-info":[{"award-number":["K01DA048494"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"USAID PEER","award":["5-601"],"award-info":[{"award-number":["5-601"]}]},{"name":"Empire Clinical Research Investigator Program (ECRIP) from the New York State Health De-partment","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study assessed the prevalence of prenatal smoking, factors associated with prenatal smoking, and its association with birth outcomes in a sample of pregnant women in Egypt. Pregnant women were recruited during their last trimester from antenatal clinics in Cairo from June 2015 to May 2016. Participants completed an interviewer-administered survey that assessed tobacco use and attitudes, and exhaled carbon monoxide (CO) was measured. Gestational age at delivery and offspring birth weight were collected via a postnatal phone interview. Two hundred pregnant women ages 16\u201337 years participated. More than a quarter (29.0%) of women reported smoking (cigarettes, hookah, or both) during their current pregnancy, and hookah was more popular than cigarettes. Most women who smoked prior to their current pregnancy either maintained their current smoking habits (46.6%) or switched from dual to hookah-only smoking (46.6%). Current smokers during pregnancy had a higher mean (\u00b1SD) exhaled CO level (2.97 \u00b1 1.45 vs. 0.25 \u00b1 0.60 ppm, p &lt; 0.001) and had babies with a lower mean birth weight (2583 \u00b1 300 vs. 2991 \u00b1 478 g, p &lt; 0.001) than non-smokers. Smokers during pregnancy had greater odds of premature birth and\/or low birth weight babies compared to non-smokers. Dual cigarette-hookah smokers had the highest risk. Additional focused programs are required to prevent women of childbearing age from initiating tobacco use and empower women to stop tobacco use during the preconception and gestational periods.<\/jats:p>","DOI":"10.3390\/ijerph182412974","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T21:46:58Z","timestamp":1639086418000},"page":"12974","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Exclusive and Dual Cigarette and Hookah Smoking Is Associated with Adverse Perinatal Outcomes among Pregnant Women in Cairo, Egypt"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-6377","authenticated-orcid":false,"given":"Omar","family":"El-Shahawy","sequence":"first","affiliation":[{"name":"Department of Population Health, New York University School of Medicine, New York, NY 10016, USA"},{"name":"School of Global Public Health, New York University, New York, NY 10013, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2486-0833","authenticated-orcid":false,"given":"Kareem","family":"Labib","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo 11517, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6063-1523","authenticated-orcid":false,"given":"Elizabeth","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-6160","authenticated-orcid":false,"given":"Linda G.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Population Health, New York University School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8349-4792","authenticated-orcid":false,"given":"Wagida","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Community and Environmental Medicine, Faculty of Medicine, Ain Shams University, Cairo 11517, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Oncken","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1687-6587","authenticated-orcid":false,"given":"Tom","family":"Loney","sequence":"additional","affiliation":[{"name":"College of Medicine, Mohammed Bin Rashid University of Medicine and Heath Sciences, Dubai P.O. Box 505055, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-7303","authenticated-orcid":false,"given":"Scott E.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-2658","authenticated-orcid":false,"given":"Erin L.","family":"Mead-Morse","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"ref_1","unstructured":"General, S. (2001). Health Consequences of Tobacco Use among Women, Reproductive Outcomes. 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