Smoking is one of the modifiable risk factors for adverse maternal and neonatal outcomes and is associated with low birth weight, preterm birth, respiratory, antepartum and intrapartum stillbirth, and perinatal death as well as long-term morbidity in offspring and sudden unexpected infant death. The rate of smoking in low- and middle-income countries is still relevantly high, and Jordan is no exception. To investigate the effect of active and passive smoking during pregnancy on adverse pregnancy outcomes. The case-control study was conducted in Jordan in June 2020. Healthy women with full-term singleton pregnancy (n = 180) were interviewed and stratified into three groups: Group I, active smokers; Group II, passive smokers; and Group III, nonsmokers. The study variables included demographic data, current pregnancy history, cotinine level of mothers and newborns, and perinatal outcomes. Statistical analysis was performed using the application package IBM SPSS 25. Various algorithms of statistical analysis were used depending on the type of distribution of feature and data quality. The threshold for statistical significance was set at p < 0.05. Active smokers had significantly lower gestational age at delivery compared to passive and nonsmoking women (p = 0.038 and p = 0.003, respectively). Neonates from active smoking mothers had significantly lower birth weight compared to neonates from passive and nonsmoking women (p = 0.016 and p = 0.019, respectively), significantly lower head and chest circumferences compared to babies from passive smokers (p < 0.001 and p = 0.036, respectively), and significantly lower first-minute Apgar score compared to those from nonsmoking women (p = 0.023). The urine cotinine level was significantly higher in both active and passive smoking women (both p < 0.01), and it was significantly higher in newborns who had been exposed to smoking in utero despite maternal active or passive smoking status (both p < 0.001). There was a weak negative correlation between urine cotinine level and birth weight: r = –0.14 for maternal cotinine level and r = –0.15 for neonate cotinine level. The current study illustrated that smoking during pregnancy leads to offspring with reduced birth weight, birth length, and head and chest circumference; reduces delivery gestational age; and lowers the first-minute Apgar score. Our study findings highlight the need for further research issued to smoking effects on perinatal outcomes, the implementation of actions to develop cessation interventions in the preconception period, and an evaluation of useful interventions to enhance a smoking-free environment during pregnancy.

Objectives To explore knowledge and attitude about Covid‐19, among Syrian refugee mothers in the Governorate of Irbid, where the first outbreak of Covid‐19 in Jordan took place. Methods This is a cross‐section study among Syrian refugee mothers, who were pregnant or having had children. Data was collected through an online questionnaire. The survey link was distributed in April 2020, through the social network’s messaging services Facebook and WhatsApp. Contact information was obtained from local community centers and non‐governmental organizations in the town of Irbid, the north of Jordan. Results 389 Syrian refugee mothers participated in the study. It showed that 66% of mother's access information regarding Covid‐19. The main sources of information were Facebook 87%, WhatsApp 69%, television 53%, while 21% indicated that they access professional databases or government websites. In general, Syrian refugee mothers were knowledgeable about Covid‐19 transmission and prevention. However, they lacked adequate knowledge about transmission of Covid‐19 between the mother and the child, and smoking risks associated with Covid‐19. Conclusions There are gaps in the knowledge and attitude of Syrian refugee mothers in the Governorate of Irbid in relation to the Covid‐19 pandemic. There is a need for further health education measures.

Background and Objectives: Miscarriage is a complication that is influenced by many risk factors that have been reported in different studies and that vary among countries. Despite the influence of various known risk factors for miscarriage, 30% to 50% of miscarriages are from unidentified causes. The aim of this study is to determine the prevalence of miscarriages in Jordan and the associated risk factors. Materials and Methods: A cross-sectional online survey was conducted in Jordan among married women to investigate the prevalence of miscarriages and identify potential risk factors. Results: Women (n = 704) were surveyed, and 17.9% reported a history of miscarriage. The identified risk factors were being an active smoker during pregnancy, having more than four children, having a family history of miscarriage, having fertility problems, receiving medical assistance for conception, and traveling by air during pregnancy. Conclusions: The results suggest that there are both modifiable and non-modifiable risk factors for miscarriages in Jordan and that a proportion of these may be preventable. The findings can be used to enhance patient awareness and inform policy development to decrease the incidence of miscarriage in the country.

Smoking during pregnancy is one of the main modifiable factors associated with perinatal morbidity and mortality and maternal complications. Literature is scant regarding smoking habits of pregnant women in Jordan. To investigate smoking patterns and attitudes of Jordanian pregnant women towards smoking. A cross-sectional survey of patterns and attitudes towards smoking among 436 mothers attending healthcare facilities in the Governorate of Irbid, Jordan, between August and September 2019. Out of 436 pregnant women in the Governorate of Irbid, Jordan, 13 (2.9%) quit smoking once pregnancy was conformed, and 77 (17.6%) continued to smoke. Pregnant non-smokers believed that hookah and electronic cigarettes are as bad to health as cigarettes, while smokers believed that hookah and electronic cigarettes are less hazardous than cigarettes (5.19% versus 21.99%, p = 0.001, and 6.49% versus 19.37%, p = 0.009, respectively). Non-smokers were significantly more aware regarding the hazards of smoking on perinatal outcomes, such as abortion (31.94% versus 10.39%, p = 0.001), placental abruption (31.94% versus 10.39%, p = 0.001), intrauterine growth restriction and fetal malformations (36.65% versus 14.29%, p = 0.007), fetal death (30.89% versus 6.49, p < 0.001), neonatal pulmonary diseases (44.50% versus 24.68%, p = 0.024), neonatal asthma (47.12% versus 28.57%, p = 0.038), and ear diseases (42.41% versus 20.8%, p = 0.012). There is a high prevalence of smokers among pregnant women in Jordan. The level of awareness regarding long-term consequences of tobacco use remains low. Educational programs should include information about the hazards of all forms of smoking. Pregnancy provides a good opportunity for promoting smoking cessation.