Smoking in pregnancy, maternal blood pressure, pregnancy outcome, baby weight and growth, and other related factors. A prospective study.

Abstract

In an interesting paper Campbell (1936), while welcoming the studies that were being concentrated on improving maternity care, drew attention to what he called "a more subtle and sinister condition", the "excessive smoking" which, during the previous two decades, had "clutched the young women of this country (America) in a manner resembling the invasion of an epidemic working in virgin soil". His paper, which was based on the conviction of his own observations, included his review of the literature and in particular a review of such experimental work as there was on the effect of nicotine or tobacco extracts. Campbell had also asked the members of the American Association of Obstetricians and Gynaecologists for their opinion about the effect of smoking 25 cigarettes or more daily on maternal health and he quoted some of the interesting replies he received, the great majority of which supported his beliefs that excessive smoking in pregnancy was harmful to the mother. There was no suggestion in his paper that smoking might also have an effect on the foetus.Since then smoking in pregnancy has received spasmodic attention. A few workers have presented evidence to suggest that smoking may prevent a successful outcome to the pregnancy (Frazier, Davis, Goldstein, and Goldberg, 1961;Zabriskie, 1963;Butler, 1965;Russell, Taylor, and Maddison, 1966;Steele and Langworth, 1966)

Size at Birth and Early Childhood Growth in Relation to Maternal Smoking, Parity and Infant Breast-Feeding: Longitudinal Birth Cohort Study and Analysis

“…The symmetrical reduction in size at birth in infants of smoking mothers suggests that this growth inhibition was present from early fetal development. Earlier and smaller studies have debated whether any size deficit persists into childhood (14,15,20). In our study, infants of smoking mothers showed complete compensatory postnatal catch-up growth in weight, and there was no significant remaining height deficit compared with other infants, however, it is still possible that deficits in bone mineral density and susceptibility to respiratory disease persist (14,20).…”

Estado nutricional e hábito de fumar maternos, crescimento intra-uterino e pós-natal

“…Quando se considera o ambiente extrauterino, onde não há influência direta do hábito de fumar materno sobre a criança, observa-se que ao final do primeiro ano de vida também não houve diferença significativa entre as médias de peso e altura dos filhos de fumantes e não-fumantes (Tabela 14), confirmando os estudos de Russel e col. 20 .…”

“…Haworth e col. 12 constataram que obesidade materna e fumo agem independentemente, e o excesso de peso materno não protege o feto contra o crescimento retardado resultante do fumo, pois nem o crescimento fetal retardado nas fumantes, nem o crescimento fetal aumentado nas obesas era explicado baseado na energia ingerida através da dieta. Russel e col. 20 afirmam que com um ano de idade, filhos de fumantes e não-fumantes pesam quase igual.…”

Use of non-aspirin NSAIDs during pregnancy may increase the risk of spontaneous abortion

“…However, maternal, paternal and environmental exposure to smoking are all associated with increased incidence of spontaneous abortion 2. Moreover, patients with a BMI>25 kg/m2 have significantly higher odds of spontaneous abortion 3 4. The lack of consideration of these covariates makes the findings less credible.…”