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European Journal of Public Health, Volume 11, Issue 3, pp. 334-339: Abstract.
October 30, 2001
N Lelongz, M Kaminski, M-J Saurel-Cubizolles, and M-H Bouvier-Colle
INSERM Unit 149, Epidemiological Research on Women's Health and Perinatal Health, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France zCorresponding author Tel: +33 1 45 595002 Fax: +33 1 45 595089
Background. Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse.
Method. Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. smoking status was recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social and those who had not, and among quitters, who had resumed smoking postpartum and those who had not.
Results. In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking relapse was the partner's smoking behaviour.
Conclusion. Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they are smokers.
Keywords: Postpartum, pregnancy, smoking partners, tobacco smoking
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Oct 31 01 6:49 PM
FACT SHEET NO. 7
July 2001
SMOKING, SEX & REPRODUCTION
Introduction
Cigarette smoking can affect women's fertility; men's fertility; sexual function in men; pregnant women's health; the health of an unborn child; and the health of young children.
Fertility
Women who smoke may have reduced fertility. One study found that 38% of non-smokers conceived in their first cycle compared with 28% of smokers. Smokers were 3.4 times more likely than non-smokers to have taken more than one year to conceive. It was estimated that the fertility of smoking women was 72% that of non-smokers.[1] A recent British study found that both active and passive smoking was associated with delayed conception.[2] Cigarette smoking may also affect male fertility: spermatozoa from smokers has been found to be decreased in density and motility compared with that of non-smokers.[3]
Male sexual impotence
Impotence, or penile erectile dysfuntion, is the repeated inability to have or maintain an erection. One US study of men between the ages of 31 and 49 showed a 50% increase in the risk of impotence among smokers compared with men who had never smoked.[4] Another US study, of patients attending an impotence clinic, found that the number of current and ex-smokers (81%) was significantly higher than would be expected in the general population (58%).[5]
Overall smoking increases the risk of impotence by around 50% for men in their 30s and 40s. ASH and the British Medical Association have calculated that around 120,000 UK men in this age group are needlessly impotent as a result of smoking.[6]
Smoking and oral contraceptives
For younger women, smoking and the use of oral contraceptives increases the risk of a heart attack, stroke or other cardiovascular disease by tenfold. This effect is even more marked in women over 45.[7] It is therefore important that all women who take the contraceptive pill be advised not to smoke.
Smoking and pregnancy
Approximately one-quarter of pregnant women in the UK smoke. Women who smoke in pregnancy are more likely to be younger, single, of lower educational achievement and in unskilled occupations. The male partner is more likely to smoke. Only one in four women who smoke succeed in stopping at some time during pregnancy. Almost two-thirds of women who succeed in stopping smoking in pregnancy restart again after the birth of their baby.[8] In December 1998, the Government set a target to reduce the percentage of women who smoked during pregnancy from 23% to 15% by the year 2010, with a fall to 18% by 2005.[9] This will mean approximately 55,000 fewer women in England who smoke during pregnancy.
Foetal growth and birth weight
Babies born to women who smoke are on average 200 grams (8 ozs) lighter than babies born to comparable non-smoking mothers. Furthermore, the more cigarettes a woman smokes during pregnancy, the greater the probable reduction in birth weight. Low birth weight is associated with higher risks of death and disease in infancy and early childhood. The adverse effects of smoking in pregnancy are due mainly to smoking in the second and third trimesters. Therefore, if a woman stops smoking within the first three months of pregnancy, her risk of having a low‑weight baby will be similar to that of a non-smoker. 8
Spontaneous abortion
The rate of spontaneous abortion (miscarriage) is substantially higher in women who smoke. This is the case even when other factors have been taken into account.8
Other complications of pregnancy
On average, smokers have more complications of pregnancy and labour which can include bleeding during pregnancy, premature detachment of the placenta and premature rupture of the membranes.[10] Some studies have also revealed a link between smoking and ectopic pregnancy 10 and congenital defects in the offspring of smokers.[11]
Perinatal mortality
Perinatal mortality (defined as still‑birth or death of an infant within the first week of life) is increased by about one-third in babies of smokers. This is equivalent to approximately 420 deaths per year in England and Wales. The increased perinatal mortality in smoking mothers occurs particularly among manual socio-economic groups and in groups that are already at high risk of perinatal death, such as older mothers or those who have had a previous perinatal death. More than one-quarter of the risk of death due to Sudden Infant Death Syndrome (cot death) is attributable to maternal smoking (equivalent to 365 deaths per year in England and Wales).8
Passive smoking and pregnancy
Exposure by the mother to passive smoking has also been associated with lower birth weight, a higher risk of perinatal mortality and spontaneous abortion.[12]
Breast feeding
Research has shown that smoking cigarettes may contribute to inadequate breast milk production. In one study, fat concentrations were found to be lower in the milk from mothers who smoked and milk volumes were lower.[13]
Health and long‑term growth
Infants of parents who smoke are twice as likely to suffer from serious respiratory infection than the children of non-smokers. (See also Fact Sheet No. 8, Passive Smoking.) Smoking in pregnancy may also have implications for the long term physical growth and intellectual development of the child. It has been associated with a reduced height of children of smoking mothers as compared with non-smoking mothers, with lower attainments in reading and mathematics up to age 16 and even with the highest qualification achieved by the age of 23.[14] One study has demonstrated a link between maternal smoking during pregnancy and adult male crime.[15] There is also evidence that smoking interferes with women's hormonal balance during pregnancy and that this may have long-term consequences on the reproductive organs of her children.[16]
Smoking and cervical cancer
Epidemiological studies have found that women who smoke have up to four times higher risk of developing cervical cancer than non-smokers and that the risk increases with duration of smoking. Studies have demonstrated biochemical evidence that smoking is a causal factor in cervical cancer.[17][18]
Smoking and the menopause
The natural menopause occurs up to two years earlier in smokers. The likelihood of an earlier menopause is related to the number of cigarettes smoked, with those smoking more than ten cigarettes a day having an increased risk of an early menopause.[19] New research suggests that polycyclic aromatic hydrocarbons found in tobacco smoke can trigger premature egg cell death which may in turn lead to earlier menopause. [20]
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NEW YORK (Reuters Health) - Nicotine exposure in the womb, even in the absence of other substances present in tobacco smoke, may lead to breathing difficulties in newborns, results of an animal study suggest.
The findings indicate that nicotine can have lasting harmful effects on developing fetal lungs, according to Dr. Hakan Sundell and colleagues of Vanderbilt University School of Medicine in Nashville, Tennessee.
"The issue is of clinical significance, because nicotine replacement for pregnant women is often regarded as a safe alternative in smoking cessation programs," they write in the American Journal of Respiratory and Critical Care Medicine.
The study involved a group of lambs that were exposed during their last trimester in the womb to nicotine through pumps that had been implanted in their mothers. The level of nicotine was equivalent to what a human fetus would be exposed to if a pregnant woman smoked mildly to moderately, the report indicates. A second group of lambs was not exposed to nicotine.
For a 5-week period after the lambs were born, various lung function tests showed that the animals exposed to nicotine in the womb had faster and more shallow breathing than those that had not been subjected to nicotine, according to the report.
"Prenatal nicotine exposure appears to have long-term effects on the postnatal breathing pattern, suggesting altered lung function," Sundell and colleagues write. "These changes are most marked close to birth but persist during the initial postnatal period."
Nicotine easily passes through the human placenta to a developing fetus, the researchers point out. And concentrations of nicotine in the fetus can be equal to or higher than in the mother, they add.
SOURCE: American Journal of Respiratory and Critical Care Medicine 2002;166:92-97.
Copyright © 2002 Reuters Limited. All rights reserved
http://story.news.yahoo.com/news?tmpl=story&u=/nm/20020712/hl_nm/children_nicotine_dc_1
Jul 13 02 7:34 PM
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
Correspondence and requests for reprints should be addressed to Håkan W. Sundell, M.D., Professor of Pediatrics, Vanderbilt University School of Medicine, U-1212, MCN, Nashville, Tennessee 37232-2585. E-mail: hakan.sundell@mcmail.vanderbilt.edu
Maternal smoking during pregnancy is a risk factor for sudden fetal and infant death as well as obstructive airway disease in childhood. Fetal nicotine exposure affects organ development. The aim of the present study was to investigate effects of fetal nicotine exposure on lung function in young lambs. Nine unanesthetized, awake, prenatally nicotine-exposed lambs (N) (approximate maternal dose: 0.5 mg/kg) and 12 nonexposed control lambs (C) were studied repeatedly for 5 weeks after birth using a pneumotachograph and a computerized method for breath-by-breath determinations. N and C lambs had similar minute ventilation but a markedly different breathing pattern. At both 5 and 21 days, average age, N lambs had significantly lower tidal volumes and higher respiratory rates than C lambs. Inspiratory drive (P0.1) and effective impedance were significantly higher in N lambs compared with C lambs only at 5 days. Prenatal nicotine exposure appears to have long-term effects on the postnatal breathing pattern, suggesting altered lung function, e.g., increased airway resistance, decreased lung compliance, or both. The increased inspiratory drive is most likely secondary to increased impedance of the respiratory system. These changes are most marked close to birth but persist during the initial postnatal period.
Key Words: respiration • respiratory mechanics • nicotine • prenatal exposure delayed effects • tobacco
Jul 30 02 3:56 PM
July 29, 2002 --- If you're pregnant and still hooked on cigarettes, here's another reason to quit - smoking may increase your baby's risk of developing autism.
Researchers at the Karolinska Institute in Sweden found that pregnant women who smoke regularly are 40 percent more likely to have autistic kids.
The study of 2,000 kids and their mothers found that smoking appears to restrict growth in the womb, contributing to the condition.
Dr. Christina Hultman said similar research on animals revealed that exposure to nicotine while in the womb has physical and behavioral effects that leads to problems with brain function.
Autism is a developmental disability that affects the way a person communicates and interacts with other people.
People with autism cannot relate to others in a meaningful way, and they also have trouble making sense of the world at large.
As a result, their ability to develop friendships is impaired and they have a limited capacity to understand other people's feelings. Autism is also often also associated with learning disabilities.
Smoking during pregnancy has also been linked to other problems in kids, including stunted growth and respiratory problems.
Pregnant women who smoke are urged immediately to contact their doctor to get on a cessation program.
Copyright 2002 NYP Holdings, Inc. All rights reserved.
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