The impact of secondhand smoke exposure on the pregnancy outcome: a prospective cohort study among Egyptian community

Abstract

Background Secondhand smoke (SHS) exposure gained lesser interest than active smoking. There is evidence from previous studies that SHS exposure had negative effects on fetal growth. This study aimed to examine the effect of smoke exposure on pregnancy outcome and to evaluate the level of nicotine urinary end-product cotinine in pregnant women in the late trimester. We included 36 women with a history of SHS exposure and 48 women without a history of exposure; all were in last trimester of pregnancy. We measured cotinine level in urine and followed the two groups until delivery and recorded fetal outcomes. Fetal biophysical parameters and blood flow waveforms were measured using B-mode and Doppler ultrasonography, respectively. Results The total range of the urinary cotinine creatinine ratio (CCR) concentration in the SHS exposed pregnant women was 0.01–0.2, IQR = 0.18 ng/mg.cr, versus 0.01–0.1, and IQR = 0.03 ng/mg.cr in the non-exposed group. The mean value as well as the mean rank of CCR was significantly higher (0.1 ± 0.08 ng/mg.cr., 40.3 respectively) in the exposed pregnant women as compared to the non-exposed pregnant women ((0.04 ± 0.02), 29.3 respectively, p value < 0.05). Newborn of the exposed women had significantly low birth weight which negatively correlated with cotinine level and had a dose-response relationship. Conclusions SHS exposure had negative effects on fetal outcomes. Efforts should be utilized to increase awareness of the consequences of secondhand smoke on the fetus and strict follow-up of exposed women for early detection.

Prevalence and factors associated with second hand smoke exposure among a sample of pregnant women in Cairo, Egypt

“…Consequently, a majority of SHS smoke exposure occurs at home [ 3 – 25 , 35 ]. This is particularly apparent in more rural and lower SES populations that are often more culturally conservative and more traditional, as can be seen in this study and previous research in the region, [ 9 ] where women in rural and low SES areas are more likely to be exposed to SHS in the home. Successful interventions promoting SHS avoidance behaviors have included a combination of improving both attitude and self-efficacy [ 25 , 36 ].…”

“…Distinct gender roles, in which men take precedence over women in shaping the social practices at home, [ 24 ] may lead to a perceived inability by women to ask family members not to smoke in the home [ 23 ]. As observed in Egypt and other Middle Eastern countries, women often feel they have limited autonomy over SHS exposure in the home [ 3 , 9 , 22 – 25 ]. Indeed, a primary obstacle to SHS avoidance has been cited as having men in the household who smoke [ 22 , 23 ].…”

“…Maternal smoking, as well as exposure to SHS, is associated with increased risks for adverse birth outcomes and maternal complications [ 5 ]. SHS exposure carries similar risks for pregnant women compared with active smoking, [ 5 – 7 ] and women exposed to SHS are more likely to give birth to infants with a lower birth weight, [ 8 , 9 ] reduced birth length, [ 10 ] smaller head circumference, [ 11 ] and stillbirth [ 12 ]. There is no safe level of exposure to SHS for non-smokers.…”

“…Despite these rules, there is little policy enforcement. The lack of policy enforcement comes at the expense of women and children, who are usually victims of high levels of SHS exposure in Middle Eastern countries [ 3 , 9 , 22 – 26 ]. Moreover, many of these policies aim only to limit smoking in public places; however, women are still vulnerable due to the high prevalence and duration of SHS exposure in their homes [ 3 , 26 ].…”

Assessment of Nicotine Dependence and Its Potential Predictors Among a Cohort of Current Egyptian Cigarette Smokers - A Preparatory Phase of a Workplace Anti-Smoking Initiative: Part I

“…000 children in the world die each year due to illnesses related to second-hand smoke. Exposure of pregnant women to tobacco smoking either directly through active smoking or indirectly through passive smoking can lead to several lifelong health conditions for babies [2]. According to the most recent statistics in 2023, the total smoking rate in Egypt is 21.4% where 42.3% of Egyptian males are smokers versus 0.4% of females [3].…”