Objective-To evaluate the effect of maternal cigarette smoking on placental histology in women with abruption.Study design-Data were derived from the New Jersey-Placental Abruption Study (NJ-PAS)-an ongoing, case-control study, conducted since August 2002 in two large hospitals in NJ. Abruption cases were identified based on a clinical diagnosis. Histological evaluations were performed by two perinatal pathologists who were blinded to the abruption status. Maternal smoking during pregnancy was determined based on patient's self report. Among abruption cases, histological findings were compared between smokers and non-smokers, and the association expressed as odds ratio (OR) with 95% confidence interval (CI). All analyses were adjusted for potential confounders.Results-A total of 189 abruption cases were available for analysis, of which 10.6% (n=20) were smokers. Intervillous thrombus was more common in women who smoked (20%) than in nonsmokers (3.0%) (OR 17.5, 95% CI 3.1, 99.4). However, placental infarcts were seen less frequently among smokers than non-smokers (10.0% vs 32.5%; OR 0.2, 95% CI 0.1, 0.8).Conclusion-These findings suggest that different pathologic mechanisms may be responsible for the histologic findings between smokers and non-smokers diagnosed with placental abruption. KeywordsPlacental abruption; smoking; villous fibrosis; intervillous thrombus; microinfarcts; trophoblast knotting Placental abruption complicates approximately 1% of all pregnancies, 1, 2 with an increase in its incidence over time. 3 This condition is associated with significant maternal morbidity and Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The association of maternal smoking with placental abruption has been well documented with studies reporting relative risks of 1.4 to 2.5. 9-11 Cigarette use is associated with a 2.5 fold increase in severe abruption resulting in fetal death. 9 The risk of abruption increases with the number of cigarettes smoked per day, 11 with a threshold effect at approximately 10 cigarettes per day after which the risk remains constant. 12 NIH Public AccessStudies focusing on smoking-related placental abruption pathology are sparse. These studies allude to the mechanism of abruption in smokers that is initiated by decidual necrosis at the margin of the placenta. 13, 14 Maternal smoking has been shown to decrease placental blood flow. 15 This effect may be mediated through changes in production of vasoactive substances, such as prostacyclin and nitric oxide, 16 or endothelial cell damage. 17The sequence of events in the placentas of smokers leading t...
The likelihood of SGA to recur within sibships is strong, with varying magnitude of risks between singleton-singleton and singleton-twin births.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.