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Original article

Vol. 140 No. 5152 (2010)

Maternal smoking during pregnancy and foetal growth

  • S Kayemba-Kay's
  • A Ribrault
  • A Burguet
  • JB Gouyon
  • D Riethmuller
  • A Menget
  • P Hindmarsh
DOI
https://doi.org/10.4414/smw.2010.13139
Cite this as:
Swiss Med Wkly. 2010;140:w13139
Published
20.12.2010

Summary

OBJECTIVE: To evaluate the effects of maternal smoking during pregnancy on foetal growth in preterm infants with gestational age (GA) <33 weeks.

POPULATION AND METHODS:Prospective observational cross-sectional study from two French perinatal networks cohort of preterm infants. Cases were 358 very preterm infants (GA 24–32 weeks) divided into two groups as maternal smokers (129) and non-smokers (229). 361 term infants (GA 37–41 weeks) also divided into two groups as maternal smokers (129) and non-smokers (232) served as comparison group (controls). We studied the influence of maternal smoking on foetal anthropometric growth parameters (BW, BL and head circumference defined according to AUDIPOG curves) in groups and compared cases and controls. Other causes of foetal growth restriction were excluded.

RESULTS: Maternal characteristics (age, height, pre-pregnancy body weight, parity, foetus sex) were similar in both groups and sub-groups. Mothers who smoked were younger (P <0.001), more likely to be unemployed (P <0.001) and to have undergone less school education (P <0.001).

Smoking did not alter foetal growth in preterm infants: maternal smokers versus non-smokers BW (P = 0.52), BL (P = 0.44) and HC (P = 0.81). Growth restriction was marked in term infants with BW (P <0.001), BL (P <0.001) and HC (P <0.01). In multivariate analysis, after adjustment for other confounding factors, foetal growth appeared to be significantly altered by maternal smoking during pregnancy only in term infants.

CONCLUSION: Our study suggests that effects of maternal smoking during pregnancy on foetal growth are gestational age-dependent.

References

  1. Hui-Ju Tsai, Xin Liu, Karen Mestan, Yunxian Yu, Shanchun Zhang, Yaping Fang, et al. Maternal smoking, metabolic gene polymorphisms and preterm delivery: a new insights on GXE interactions and pathogenic pathways. Hum Gen. 2008;123:359–69.
  2. Desforges M, Sibley CP. Placental nutrients supply and foetal growth. Int J Dev Biol. 2010;54:377–90.
  3. Conférence de consensus ANAES 2004: grossesse et tabac.
  4. McCowan LME, Dekker GA, Chan E, Stewart A, Chappell LC, Hunter M, et al. Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. 2009;338:1–6.
  5. Lewis KW, Bosque EM. Deficient hypoxia awakening response in infants of smoking mothers: possible relationship to sudden infant death syndrome. J Pediatr. 1995;127:691–9.
  6. Ueda Y, Stick SM, Hall G, Sly PD. Control of breathing in infants born to smoking mothers. J Pediatr. 1999;135:226–32.
  7. Simpson WJ, Linda LA. A preliminary report in cigarette smoking and the incidence of prematurity. Am J Obstet Gynecol. 1957;73:808–15.
  8. Chiolero A, Bovet P, Paccaud F. Association between maternal smoking and low birth weight in Switzerland: the EDEN study. Swiss Med Wkly. 2005;135:525–30.
  9. Pringle PJ, Geary PP, Rodeck CH, Kingdom JCP, Kayamba-Kay’s S, Hindmarsh PC. The influence of cigarette smoking on antenatal growth, birth size, and the insulin-like growth factors axis. J Clin Endocrinol Metab. 2005;90:2556–62.
  10. Ingvarsson R, Bjarnason AO, Dagbjartsson A, Hardardottir H, Haraldsson A, Thorkelsson T. The effects of smoking in pregnancy on factors influencing foetal growth. Acta Paediatr. 2007;96:383–6.
  11. Anderson GD, Blidner IN, McClemont S, Sinclair JC. Determinants of size at birth in a Canadian population. Am J Obstet Gynecol. 1984;150:236.
  12. Vik T, Jacobsen G, Vatten L, Bakkeitig LS. Pre- and post-natal growth in children of women who smoked in pregnancy. Early Hum Dev. 1996;45:245–55.
  13. Ahlsten G, Cnattingius S, Lindmark G. Cessation of smoking during pregnancy impoves foetal growth and reduces infant morbidity in the neonatal period. A population-based prospective study. Acta Paediatr. 1993;82:177–81.
  14. Suzuki K, Tanaka T, Kondo N, Minai J, Sato M, Yamagata Z. Is maternal smoking during early pregnancy a risk factor for all low birth weight infants? J Epidemiol. 2008;18:89–96.
  15. Jaddoe VWV, Troe EWM, Hofman A, Mackenbach JP, Moll HA, Steegers EAP, Witteman JCM. Active and passive maternal smoking during pregnancy and preterm birth: the generation R study. Paediatr Perinat Epidemiol. 2008;22:162–71.
  16. Ohmi H, Hirooka K, Mochizuki Y. Foetal growth and timing of exposure to maternal smoking. Pediatr Int. 2002;44:55–9.
  17. Lieberman E, Gremy I, Lang JM, Cohen AP. Low birthweight at term and the timing of Foetal exposure to maternal smoking. Am J Public Health. 1994;84:1127–31.
  18. Hebel JR, Fox NL, Sexton M. Dose-response of birth weight to various measures of maternal smoking during pregnancy. J Clin Epidemiol. 1988;41:483.
  19. Lang JM, Cohen A, Lieberman E. Risk factors for small-for- gestational age at birth in a preterm population. Am J Obstet Gynecol. 1992;166:1374–8.
  20. Macarthur C, Knox EG. Smoking in pregnancy: effects of stopping at different stages. Br J Obstet Gynaecol. 1988;95:551–5.
  21. Vielwerth SE, Jensen RB, Larsen T, Greisen G. The impact of maternal smoking on foetal and infant growth. Early Hum Dev. 2007;83:491–5.
  22. Mamelle N, Munoz F, Grandjean H. Croissance fœtale à partir de l’étude AUDIPOG, l’établissement de courbe de référence. J Gynecol Obstet Biol Reprod. 1996;25:61–70.
  23. Bernstein IM, Plociennik K, Stahle S, Badger GJ, Secker-Walker R. Impact of maternal smoking on foetal growth and body composition. Am J Obstet Gynecol. 2000;183:883–6.
  24. Fitzgerald K, Cai J, Hoff G, Dew P, Okah F. Clinical manifestation of small-for-gestational-age risk pregnancy from smoking is gestational age dependent. Am J Perinatol. 2007;24:519–24.
  25. Jaddoe VW, Verburg BO, De Ridder MA, Hofman A, Mackenbach JP, Moll HA, et al. Maternal smoking and foetal growth characteristics in different periods of pregnancy: the generation R study. Am J Epideiol. 2007;165:1207–15.
  26. Lindey AA, Becker S, Gray RH, Herman AA. Effects of continuing or stopping smoking during pregnancy on infant birth weight, crown-heel length, head circumference, ponderal index, and brain: body weight ratio. Am J Epidemiol. 2000;152:219–25.
  27. Klauwer D, Blum WF, Hanitsch S, Bascher W, Lee PD, Kiess W. IGF-I, IGF-II, free IGF-I and IGF-BP-1, -2 and –3 levels in venous cord blood: relationship to birth weight, length and gestational age in healthy newborns. Acta Paediatr. 1997;86:826–33.
  28. Kayemba-Kay’s S, Geary MP, Pringle J, Rodeck CH, Kingdom JC, Hindmarsh PC. Gender, smoking during pregnancy and gestational age influence cord leptin concentrations in newborn infants. Eur J Endocrinol. 2008;159:217–24.
  29. Mantzoros CS, Varvarigou A, Kaklamani VG, Beratis NG, Flier JS. Effects of birth weight and maternal smoking on cord blood leptin concentrations of full-term and preterm newborns. J Clin Endocrinol Metab. 1997;82:2856–61.
  30. Helland IB, Reseland JE, Saugstad OD, Drevon CA. Smoking related to plasma leptin concentration in pregnant women and their newborn infants. Acta Paediatr. 2001;90:282–7.
  31. Jauniaux E, Burton GJ. Morphological and biological effects of maternal exposure to tobacco smoke on feto-placental unit. Early Hum Dev. 2007;83:699–706.
  32. Hutcheon JA, Platt RW. The missing data problem in birth weight percentiles and thresholds for small for gestational age. Am J Epidemiol. 2008;167:786–92.
  33. Gardosi J, Chang A, Kalyan B, Sahota D, Symonds EM. Customised antenatal growth charts. Lancet. 1992;339:283–7.
  34. Burguet A, Berard M, Woronoff AS, Roth P, Menetrier M, Vanlemmens P, Schaal JP, Menget A. An appreciation of maternal smoking with high-performance liquid chromatographic determination of maternal and neonatal urinary cotinine. J Gynecol Obstet Biol Reprod. (Paris). 2001;30:166–73. French.
  35. Klebanoff M, Levine R, Clemens JD, DerSimonian R, Wilkins DG. Serum cotinine concentration and self-reported smoking during pregnancy. Am J Epidemiol. 1998;148(3):259–62.
  36. Bolliger CT, Van Biljon X, Humair JP, El Fehri V, Cornuz J. Promoting hospital-based smoking cessation services at major Swiss hospitals: a before and after study. Swiss Med Wkly. 2008;138:427–31.