North American Registry of Midwives (NARM) Practice Exam

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Smoking during pregnancy is associated with a higher risk of which of the following adverse outcomes?

Postpartum depression
Low birth weight
Gestational diabetes
Ectopic pregnancy

The correct answer is: Low birth weight

Smoking during pregnancy has been well-documented to be associated with numerous adverse outcomes for both the mother and the developing fetus. One of the most significant risks linked to maternal smoking is low birth weight. Low birth weight is defined as a birth weight of less than 5.5 pounds (2500 grams) and is particularly concerning as it is associated with increased morbidity and mortality in newborns. Smoking can lead to reduced oxygen and nutrient availability to the fetus, which can impair fetal growth and development. Nicotine and other harmful substances found in tobacco can cause constriction of blood vessels, ultimately reducing the blood flow to the placenta and impacting fetal development, which frequently results in a lower than average birth weight. In contrast, while other options like postpartum depression, gestational diabetes, and ectopic pregnancy carry their own risks and associations with pregnancy, the direct link between smoking and the risk of giving birth to a low-weight baby is one of the most notable and well-established findings in maternal-fetal health research. This emphasizes the importance of smoking cessation during pregnancy to improve outcomes for mothers and their babies.