Increased cerebral blood flow velocities in newborn infants of smoking mothers

Abdul-Khaliq, H.; Segerer, Hugo; Luck, W. A. P.; Obladen, Michael

doi:10.1007/bf01956151

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…Smoking of one cigarette in an uneventful pregnancy does not produce acute hemodynamic effects in the fetus [15]. There is no evidence of other cardiovascular effects or centralization in healthy fetuses of normal pregnancies, but this might not be true in fetuses of pathologic pregnancies [12]. Our results showed a statistically significant incidence of meconium in the amniotic fluid as a sign of circulation centralization as a compensatory mechanism for hypoxia in the fetuses of chronic smokers (120 cigarettes/day).…”

Section: Discussionsupporting

confidence: 58%

“…The study of Spinillo et al [11] indicates that cigarette smoking during the latter half of pregnancy increases the risk of intracranial hemorrhage in preterm infants. The deleterious effect of smoking was greater for mild hemorrhages and was confined to infants of heavy smokers, also, prenatal tobacco smoke exposure is related to increased cerebral blood flow velocities in newborn infants [12].…”

Section: Discussionmentioning

confidence: 99%

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Fetal Tobacco Syndrome and Perinatal Outcome

Habek

Ivanišević³

et al. 2002

Fetal Diagn Ther

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Objective: The aim of this study was to evaluate perinatal outcome in newborns of mothers who are smokers. Methods: The study included 87 pregnant women with a single pregnancy in the cephalic position, 64 of them nonsmokers (group 1), 13 who smoked 5–20 cigarettes per day (group 2) and 10 who smoked more than 20 cigarettes per day (group 3). Maternal demographic variables and laboratory hemoglobin concentration, hematocrit and erythrocyte count in the last trimester were recorded. Perinatal outcome included type of delivery (vaginal or cesarean section), birth weight, occurrence of meconium in the amniotic fluid, 5-min Apgar score, umbilical arterial blood pH postpartum, sex of the newborn, need for treatment at a neonatal intensive care unit (NICU) and clinically and neurosonographically verified postpartum neurologic complications in the newborn. Results: A statistically significant correlation (p < 0.01) was found with the mean gestational age at delivery in all three groups of women, especially in those smoking >20 cigarettes per day, who had a higher incidence of premature deliveries. Maternal laboratory findings also differed significantly among the three groups of women, i.e. erythrocyte count (p < 0.01), hemoglobin concentration (p < 0.01) and hematocrit (p < 0.001). The rate of delivery by cesarean section was significantly higher in the groups of smokers, irrespective of the number of cigarettes per day (groups 2 and 3). Birth weight was lower by about 250 and 350 g (p < 0.001) in groups 2 and 3, respectively. Five-minute Apgar score and umbilical arterial blood pH were lower in group 3 as compared with groups 1 and 2 (p < 0.01). NICU treatment was required in more than 50% of infants born to group 3 mothers, in whom 70% of perinatal neurologic complications such as subependymal hemorrhage, periventricular hemorrhage, porencephalic cysts, intracranial hemorrhage and swallowing disturbance of the newborn were recorded (p < 0.001). The infants born to group 3 mothers had a longer and more difficult period of adaptation, thus often requiring an NICU stay. Conclusion: Our study confirmed that pregnancy burdened with smoking, especially in the case of >20 cigarettes a day, is associated with a high risk due to the development of maternal anemia and fetal hypoxia and polyglobulia, which in turn result in a significantly poorer perinatal outcome in infants born to smoking mothers and compromised subsequent development of the child, as evidenced by the morphological substrates on the brain resulting from the fetal mechanism of defense against hypoxia. Clinically, there was no other (etiologic) reason for (chronic) fetal hypoxia; thus, the clinical substrate of fetal tobacco syndrome could be presumed to have developed consequentially to chronic smoking during pregnancy, as a preuterine factor of fetal hypoxia. Other gestational or gestation-related diseases (e.g., gestosis, diabetes) that may potentially cause nutritional and respiratory insufficiency of the placenta were ruled out.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Fetal Tobacco Syndrome and Perinatal Outcome

Habek

Ivanišević³

et al. 2002

Fetal Diagn Ther

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“…Prior studies [6,19,21,22] already studied the repercussions of smoking on maternal-fetal flow, but all have used patients' self-report to quantify tobacco smoking exposure. As mentioned previously, data reported by smoking patients are not always reliable, what might justify the heterogeneity of the results found in those studies[23].…”

Section: Discussionmentioning

confidence: 99%

Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation

Machado

Filho

Petersen

et al. 2011

BMC Pregnancy Childbirth

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BackgroundDespite the existence of various published studies regarding the effects of tobacco smoking on pregnancy, and especially in regards to placental blood flow and vascular resistance, some points still require clarification. In addition, the amount of damage due to tobacco smoking exposure that occurs has not been quantified by objective means. In this study, we looked for a possible association between flow resistance indices of several arteries and the levels of urinary cotinine and the concentration of carbon monoxide in the exhaled air (COex) of both smoking and non-smoking pregnant women. We also looked for a relationship between those findings and fetal growth and birth weight.MethodsIn a prospective design, thirty pregnant smokers and thirty-four pregnant non-smokers were studied. The volunteers signed consent forms, completed a self-applied questionnaire and were subjected to Doppler velocimetry. Tobacco smoking exposure was quantified by subject provided information and confirmed by the measurement of urinary cotinine levels and by the concentration of carbon monoxide in the exhaled air (COex). The weight of newborns was evaluated immediately after birth.ResultsComparing smoking to non-smoking pregnant women, a significant increase in the resistance index was observed in the uterine arteries (P = 0.001) and umbilical artery (P = 0.001), and a decrease in the middle cerebral artery (P = 0.450). These findings were associated with progressively higher concentrations of COex and urinary cotinine. A decrease in the birth weight was also detected (P < 0.001) in association with a progressive increase in the tobacco exposure of the pregnant woman.ConclusionsIn pregnant women who smoke, higher arterial resistance indices and lower birth weights were observed, and these findings were associated with increasing levels of tobacco smoking exposure. The values were significantly different when compared to those found in non-smoking pregnant women. This study contributes to the findings that smoking damage during pregnancy is dose-dependent, as demonstrated by the objective methods for measuring tobacco smoking exposure.

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“…Os resultados aqui encontrados mostram o IP da ACM com tendência de ser menor no grupo de fumantes, em concordância com os achados de Abdul-Khaliq et al 12 . Estes autores, estudando a dopplervelocimetria cerebral em recém-nascidos, observaram que nos filhos de mães fumantes há menor resistência na artéria cerebral anterior, artéria carótida interna e artéria basilar.…”

Section: Discussionunclassified

Influência do Tabagismo no Sistema Vascular Materno-fetal: estudo com Dopplervelocimetria

Pinto

Botelho

2000

Rev. Bras. Ginecol. Obstet.

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, em amplo estudo de meta-aná-lise, reviu e confirmou a forte associação do tabagismo com um elevado risco de placenta pré-via, descolamento prematuro de placenta, gravidez ectópica e ruptura prematura de membrana, e um risco diminuído para pré-eclâmpsia.A dopplervelocimetria na gestação, por sua ampla aplicação clínica, devido à facilidade do seu manuseio e da inocuidade para a paciente, torna-se extremamente importante para se avaliarem alterações vasculares decorrentes das mais variadas causas, dentre elas as relacionadas com o tabagismo.A nicotina e o monóxido de carbono são as substâncias que mais provavelmente causam dano no sistema vascular materno-fetal. Os efeitos da nicotina no sistema cardiovascular, de modo geral, imitam aqueles vistos após ativação do sistema simpático adrenal, incluindo efeitos inotrópico e cronotrópico positivos no miocárdio, bem como aumento do rendimento cardíaco. Além disso, as pressões sistólica e diastólica aumentam secundariamente à estimulação do eixo

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Increased cerebral blood flow velocities in newborn infants of smoking mothers

Cited by 12 publications

References 18 publications

Fetal Tobacco Syndrome and Perinatal Outcome

Fetal Tobacco Syndrome and Perinatal Outcome

Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation

Influência do Tabagismo no Sistema Vascular Materno-fetal: estudo com Dopplervelocimetria

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