Maternal Smoking during Pregnancy and Fetal Organ Growth: A Magnetic Resonance Imaging Study

Abstract

ObjectiveTo study whether maternal cigarette smoking during pregnancy is associated with alterations in the growth of fetal lungs, kidneys, liver, brain, and placenta.DesignA case-control study, with operators performing the image analysis blinded.SettingStudy performed on a research-dedicated magnetic resonance imaging (MRI) scanner (1.5 T) with participants recruited from a large teaching hospital in the United Kingdom.ParticipantsA total of 26 pregnant women (13 current smokers, 13 non smokers) were recruited; 18 women (10 current smokers, 8 nonsmokers) returned for the second scan later in their pregnancy.MethodsEach fetus was scanned with MRI at 22–27 weeks and 33–38 weeks gestational age (GA).Main outcome measuresImages obtained with MRI were used to measure volumes of the fetal brain, kidneys, lungs, liver and overall fetal size, as well as placental volumes.ResultsExposed fetuses showed lower brain volumes, kidney volumes, and total fetal volumes, with this effect being greater at visit 2 than at visit 1 for brain and kidney volumes, and greater at visit 1 than at visit 2 for total fetal volume. Exposed fetuses also demonstrated lower lung volume and placental volume, and this effect was similar at both visits. No difference was found between the exposed and nonexposed fetuses with regards to liver volume.ConclusionMagnetic resonance imaging has been used to show that maternal smoking is associated with reduced growth of fetal brain, lung and kidney; this effect persists even when the volumes are corrected for maternal education, gestational age, and fetal sex. As expected, the fetuses exposed to maternal smoking are smaller in size. Similarly, placental volumes are smaller in smoking versus nonsmoking pregnant women.

The Effects of Preeclampsia on Perinatal Risks and Infant Temperaments Among Mothers With Antenatal Depression

“…A history of maternal smoking during the 1st and 2nd trimesters of the current pregnancy was included in the model as an additional confounder because of the well-known negative effects on both birth outcomes (Anblagan et al, 2013; Cnattingius, 2004; Pollack, Lantz, & Frohna, 2000) and infant temperament (Martin, Dombrowski, Mullis, Wisenbaker, & Huttunen, 2006; Pickett, Wood, Adamson, D'Souza, & Wakschlag, 2008; Roza et al, 2009; Stene-Larsen, Borge, & Vollrath, 2009). These confounders were included in models for statistical adjustment.…”

Smoking-Induced Changes in the Maternal Immune, Endocrine, and Metabolic Pathways and Their Impact on Fetal Growth: A Topical Review

“…A significant decrease in fetal size, brain, lung, kidney, and placental volumes was noted in the smoking versus the nonsmoking pregnant group using magnetic resonance imaging to determine the influence of PMSE [49] . The reduction in the fetal organ sizes was noted as early as 22 weeks of gestation; however, no further information was provided about the duration of PMSE and the actual timing of fetal insult.…”

The Human Placental Methylome

“…By changing structure, cell composition or gene expression, the placenta may respond to, buffer against, or adapt to the contents of maternal blood. For example, smaller and/or lighter placentas have been documented in offspring of mothers who smoke (Anblagan et al 2013), were pregnant during Ramadan fasting (Alwasel et al 2013), or were exposed to higher levels of air pollution (van den Hooven et al 2012). Larger and/or heavier placentas have been documented in offspring of mothers who are obese or endure psychosocial stress during pregnancy (Tegethoff et al 2010).…”