Pre-Eclampsia Risk To Mothers And Babies Is Greater For Smokers

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Main Category: Pregnancy / Obstetrics
Also Included In: Smoking / Quit Smoking;  Public Health;  Women's Health / Gynecology
Article Date: 27 Feb 2008 - 0:00 PDT

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The results of a new study published in the journal Hypertension reveal that if women give up smoking before or during pregnancy, they can reduce their risk of pre-eclampsia.

Pre-eclampsia is a high-risk medical condition when hypertension (high blood pressure) arises in pregnancy along with increased protein in urine; it leads to hundreds of baby deaths every year. Women who continue to smoke during pregnancy and who suffer from pre-eclampsia are risking the lives of their unborn children.

It is known that a major public health problem centers on women who smoke while pregnant. Researchers have found that about 30% of pregnant women smoke, resulting in significant health problems to the unborn child. An estimated 4000 fetal deaths (including miscarriages) every year are due to smoking while pregnant, and it can lead to premature births, low birth weight, cot death, and asthma as well as attention deficit and learning problems in childhood.

The study linking smoking and pre-eclampsia was carried out by researcher Fiona Broughton Pipkin of the University of Nottingham and colleagues from the Genetics of Pre-Eclampsia Consortium (GOPEC). Funding was provided by the British Heart Foundation.

"Pre-eclampsia and eclampsia are the second most frequent cause of death in pregnancy in this country and cause an estimated 70,000 deaths worldwide among pregnant women each year. In 2005, 742 babies died as a direct result of pregnancy hypertension in England and Wales. Ten times this number are delivered prematurely for the same reason. They risk short-term breathing problems, potential brain damage and long-term cardiovascular disease. The deaths are the tip of an iceberg for hospital admissions and worry for mothers, babies and families," explains Pipkin.

The multi-center cohort study consisted of 1001 white Western European women with moderate to severe pre-eclampsia and their babies. The researchers found that those in the group who were smokers were more likely to have premature deliveries (before 34 weeks), babies with lower birth weights, or babies with other adverse outcomes. In addition, smokers were five times more likely to develop eclampsia, characterized by convulsions or seizures.

Summarizing the study results, of the 1001 women with pre-eclampsia:

• 34.8% of smokers delivered before 34 weeks (26.8% of former smokers and 21.3% of non-smokers did).
• 46.1% of smokers had underweight babies (37.5% of former smokers and 27.9% of non-smokers did).
• 65.6% had babies with adverse outcomes (60% of former smokers and 50.4% of non-smokers did).

"Research like this study from The University of Nottingham is vital to help us understand the full effects of lifestyle choices on our heart and circulatory health and that of our children. Smoking is clearly potentially very harmful to mother and baby, and we need to support women in quitting at every stage of pregnancy," reports Ellen Mason, a cardiac nurse at the British Heart Foundation (BHF).

Professor Pipkin adds: "Although a recent article suggested that smoking in pregnancy is less damaging to the unborn baby than commonly supposed, GOPEC argues that smoking CAN make a bad situation worse for both mother and baby in pre-eclampsia."

They find that stopping smoking limits the damage.

"I feel very strongly that pregnant women should be encouraged as actively as possible to stop smoking, and this paper provides yet more reasons why," concludes Pipkin.

Researchers from the University of Nottingham, in a separate study, will analyze 1050 pregnant women to see the effects of using nicotine patches during pregnancy. The Smoking, Nicotine and Pregnancy (SNAP) trial (a £1.3m clinical trial) will study the safety and effectiveness of nicotine replacement therapy (NRT) for expectant mothers who wish to give up smoking, as well as effects on the child's behavior and development.

Smoking in Moderate/Severe Preeclampsia Worsens Pregnancy Outcome, but Smoking Cessation Limits the Damage
F. Broughton Pipkin on behalf of The Genetics of Preeclampsia Consortium
Hypertension. February 2008.
doi: 10.1161/HYPERTENSIONAHA.107.106559
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Written by: Peter M Crosta
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