Epidemiology of prenatal smoking and perinatal outcomes.

Abstract:

UNLABELLED:During the previous two decades smoking among pregnant women in the developed world declined by about 60-75%. Nevertheless, prenatal smoking remains a common habit and accounts for a significant proportion of fetal morbidity and mortality through both a direct (fetal) and an indirect (placental) effect. The most important smoking-induced placental pathology is placental abruption with reported risk estimates ranging from 1.4 to 4.0. It is almost a consensus that prenatal smoking is a causative factor for placental abruption. Although the evidence is less compelling, smoking mothers are at an increased risk for placenta previa and placenta-previa-accreta combination. There is no association between maternal smoking and the syndrome of idiopathic uterine bleeding. The relationship between maternal smoking and fetal growth is causal, and includes significant reduction in growth of head circumference, abdominal circumference and femur length, with the largest reduction in size observed for femur length. Prenatal smoking is associated with a 20-30% higher likelihood for stillbirth, a 40% elevation in the risk for infant mortality and a 2-fold increase in the incidence of SIDS. CONCLUSION:Despite a temporal decline in maternal smoking, it still accounts for significant feto-infant morbidity and mortality, and efforts to discourage prenatal smoking need to be intensified.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Salihu HM,Wilson RE

doi

10.1016/j.earlhumdev.2007.08.002

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

713-20

issue

11

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(07)00124-7

journal_volume

83

pub_type

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