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Wrześniak M, Kepinska M, Bizoń A, Milnerowicz-Nabzdyk E, Milnerowicz H. Transferrin Sialylation in Smoking and Non-Smoking Pregnant Women with Intrauterine Growth Restriction. Fetal Pediatr Pathol 2015; 34:391-9. [PMID: 26470653 DOI: 10.3109/15513815.2015.1095260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Transferrin (Tf) is a glycosylated protein responsible for transporting iron. Various sialylation levels of Tf are observed during physiological and pathological processes. We studied if the changes in iron stores as well as tobacco smoke may have an impact on foetal development and in consequence lead to intrauterine growth restriction (IUGR). In the third trimester of pregnancy, lower levels of 4-sialoTf isoform and higher levels of 5-sialoTf were observed in the serum of non-smoking women with IUGR in comparison to the control group. On the day of labour, level of 2-sialoTf was significantly lower and level of 3-sialo was Tf higher in the serum of non-smoking women. Level of 4-sialo was found lower in the serum of smoking women with IUGR than in the control group. The observed changes may suggest a connection between iron stores, transport of iron to the foetus and foetal development.
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Affiliation(s)
- Marta Wrześniak
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Marta Kepinska
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Anna Bizoń
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
| | - Ewa Milnerowicz-Nabzdyk
- b 2nd Department and Clinic of Gynaecology and Obstetrics , Wrocław Medical University , Wrocław , Poland
| | - Halina Milnerowicz
- a Department of Biomedical and Environmental Analysis , Wrocław Medical University , Wrocław , Poland
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152
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Machado JDB, Chatkin JM, Zimmer AR, Goulart APS, Thiesen FV. Cotinine and polycyclic aromatic hydrocarbons levels in the amniotic fluid and fetal cord at birth and in the urine from pregnant smokers. PLoS One 2014; 9:e116293. [PMID: 25549364 PMCID: PMC4280223 DOI: 10.1371/journal.pone.0116293] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/08/2014] [Indexed: 01/29/2023] Open
Abstract
Cigarette smoking during pregnancy has several impacts on fetal development, including teratogenic effects. The objective of this study was to assess whether the toxic substances (cotinine and polycyclic aromatic hydrocarbons) found in pregnant smokers are transmitted to their fetuses. The outcomes were analyzed measuring cotinine and 1-hydroxypyrene in the amniotic fluid and maternal urine, benzopyrene and cotinine in the umbilical cord blood. Through a controlled cross-sectional design, 125 pregnant women were selected and classified according to their smoking status: 37 current smokers, 25 passive smokers and 63 non-smokers (controls). We performed high-performance liquid chromatography to measure substances’ concentrations. A post-hoc Tukey’s test was used to analyze the differences between the groups. All variables were significantly different between controls and smokers. The mean ratios between the concentration of cotinine in smokers compared to controls were as follows: 5.9 [2.5–13.5], p<0.001 in the urine; 25 [11.9–52.9], p<0.001 in the amniotic fluid; and 2.6 [1.0–6.8], p = 0.044 in the umbilical cord blood. The mean ratios of 1-hydroxypyrene concentration between smokers and controls were 7.3 [1.6–29.6], p = 0.003 in the urine and 1.3 [1.0–1.7], p = 0.012 in the amniotic fluid, and of benzopyrene in umbilical cord blood was 2.9 [1.7–4.7], p<0.001. There were no significant differences between controls and passive smokers. When comparing the three groups together, there were statistical differences between all variables. Thus, the fetuses of pregnant smokers are exposed to toxic and carcinogens substances. To our knowledge, this is the first study to measure 1-hydroxypyrene in the amniotic fluid and benzopyrene in umbilical cord blood by high-performance liquid chromatography when considering pregnant women in relation to smoking exposure only.
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Affiliation(s)
- Julia de Barros Machado
- School of Medicine, Pontifícia Universidade Católica, Rio Grande do Sul, Porto Alegre, Brazil
| | - José Miguel Chatkin
- School of Medicine, Pontifícia Universidade Católica, Rio Grande do Sul, Porto Alegre, Brazil
| | - Aline Rigon Zimmer
- School of Pharmacy, Pontifícia Universidade Católica, Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Flávia Valladão Thiesen
- School of Pharmacy, Pontifícia Universidade Católica, Rio Grande do Sul, Porto Alegre, Brazil
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153
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Hodyl NA, Grzeskowiak LE, Stark MJ, Scheil W, Clifton VL. The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia. Med J Aust 2014; 201:274-8. [PMID: 25163379 DOI: 10.5694/mja13.11142] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 05/21/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes. DESIGN Retrospective cohort study from 1 January 1999 to 31 December 2008. SETTING All singleton births in South Australia. PARTICIPANTS Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746). MAIN OUTCOME MEASURES Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy. RESULTS Active cigarette smoking during pregnancy was associated with an increased risk of adverse perinatal outcomes, including premature labour (Aboriginal, 1-10 cigarettes per day: aOR, 1.69; 95% CI, 1.28-2.23; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.46; 95% CI, 1.34-1.58), preterm birth (Aboriginal, 1-10 cigarettes per day: aOR, 1.40; 95% CI, 1.14-1.73; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.48; 95% CI, 1.39-1.57), intrauterine growth restriction (Aboriginal, 1-10 cigarettes per day: aOR, 2.33; 95% CI, 1.77-3.08; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.65; 95% CI, 2.48-2.83) and small for gestational age (Aboriginal, 1-10 cigarettes per day: aOR, 2.49; 95% CI, 2.06-3.00; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.29; 95% CI, 2.20-2.40). For both Aboriginal and non-Aboriginal women who smoked 11 or more cigarettes per day the aOR for these outcomes increased. Smoking cessation in the first trimester reduced these risks to levels comparable with non-smokers. The risk of each adverse outcome was greater in Aboriginal than non-Aboriginal women for all smoking categories; however, interactions between Aboriginal status and smoking were not significant, indicating an equal contribution of smoking to poor outcomes in both populations. CONCLUSIONS Smoking cessation or reduction during pregnancy would significantly improve outcomes in both Aboriginal and non-Aboriginal women. This should be made a clear priority to improve pregnancy outcomes for all women.
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Affiliation(s)
- Nicolette A Hodyl
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia.
| | - Luke E Grzeskowiak
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia
| | - Michael J Stark
- Department of Neonatal Medicine, Women's and Children's Hospital, Adelaide, SA, Australia
| | - Wendy Scheil
- Pregnancy Outcome Unit, Epidemiology Branch, SA Health, Adelaide, SA, Australia
| | - Vicki L Clifton
- Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia
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154
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Inamdar AS, Croucher RE, Chokhandre MK, Mashyakhy MH, Marinho VCC. Maternal Smokeless Tobacco Use in Pregnancy and Adverse Health Outcomes in Newborns: A Systematic Review. Nicotine Tob Res 2014; 17:1058-66. [DOI: 10.1093/ntr/ntu255] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 11/17/2014] [Indexed: 11/15/2022]
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155
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Lavezzi AM, Cappiello A, Pusiol T, Corna MF, Termopoli V, Matturri L. Pesticide exposure during pregnancy, like nicotine, affects the brainstem α7 nicotinic acetylcholine receptor expression, increasing the risk of sudden unexplained perinatal death. J Neurol Sci 2014; 348:94-100. [PMID: 25433450 DOI: 10.1016/j.jns.2014.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 10/24/2014] [Accepted: 11/10/2014] [Indexed: 12/16/2022]
Abstract
This study indicates the impact of nicotine and pesticides (organochlorine and organophosphate insecticides used in agriculture) on neuronal α7-nicotinic acetylcholine receptor expression in brainstem regions receiving cholinergic projections in human perinatal life. An in-depth anatomopathological examination of the autonomic nervous system and immunohistochemistry to analyze the α7-nicotinic acetylcholine receptor expression in the brainstem from 44 fetuses and newborns were performed. In addition, the presence of selected agricultural pesticides in cerebral cortex samples of the victims was determined by specific analytical procedures. Hypodevelopment of brainstem structures checking the vital functions, frequently associated with α7-nicotinic acetylcholine receptor immunopositivity and smoke absorption in pregnancy, was observed in high percentages of victims of sudden unexpected perinatal death. In nearly 30% of cases however the mothers never smoked, but lived in rural areas. The search for pesticides highlighted in many of these cases traces of both organochlorine and organophosphate pesticides. We detain that exposition to pesticides in pregnancy produces homologous actions to those of nicotine on neuronal α7-nicotinic acetylcholine receptor, allowing to developmental alterations of brainstem vital centers in victims of sudden unexplained death.
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Affiliation(s)
- Anna Maria Lavezzi
- "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy.
| | | | - Teresa Pusiol
- Institute of Anatomic Pathology, Hospital of Rovereto (Trento), Italy
| | - Melissa Felicita Corna
- "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | | | - Luigi Matturri
- "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
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156
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Calvigioni D, Hurd YL, Harkany T, Keimpema E. Neuronal substrates and functional consequences of prenatal cannabis exposure. Eur Child Adolesc Psychiatry 2014; 23:931-41. [PMID: 24793873 PMCID: PMC4459494 DOI: 10.1007/s00787-014-0550-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/15/2014] [Indexed: 02/01/2023]
Abstract
Cannabis remains one of the world's most widely used substance of abuse amongst pregnant women. Trends of the last 50 years show an increase in popularity in child-bearing women together with a constant increase in cannabis potency. In addition, potent herbal "legal" highs containing synthetic cannabinoids that mimic the effects of cannabis with unknown pharmacological and toxicological effects have gained rapid popularity amongst young adults. Despite the surge in cannabis use during pregnancy, little is known about the neurobiological and psychological consequences in the exposed offspring. In this review, we emphasize the importance of maternal programming, defined as the intrauterine presentation of maternal stimuli to the foetus, in neurodevelopment. In particular, we focus on cannabis-mediated maternal adverse effects, resulting in direct central nervous system alteration or sensitization to late-onset chronic and neuropsychiatric disorders. We compare clinical and preclinical experimental studies on the effects of foetal cannabis exposure until early adulthood, to stress the importance of animal models that permit the fine control of environmental variables and allow the dissection of cannabis-mediated molecular cascades in the developing central nervous system. In sum, we conclude that preclinical experimental models confirm clinical studies and that cannabis exposure evokes significant molecular modifications to neurodevelopmental programs leading to neurophysiological and behavioural abnormalities.
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Affiliation(s)
- Daniela Calvigioni
- Division of Molecular Neurobiology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, 17177 Stockholm, Sweden. Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Yasmin L. Hurd
- Department of Psychiatry and Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
| | - Tibor Harkany
- Division of Molecular Neurobiology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, 17177 Stockholm, Sweden. Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Erik Keimpema
- Department of Molecular Neurosciences, Center for Brain Research, Medical University of Vienna, 1090 Vienna, Austria
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157
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White TJ, Redner R, Skelly JM, Higgins ST. Examining educational attainment, prepregnancy smoking rate, and delay discounting as predictors of spontaneous quitting among pregnant smokers. Exp Clin Psychopharmacol 2014; 22:384-91. [PMID: 25069014 PMCID: PMC4180793 DOI: 10.1037/a0037492] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We investigated three potential predictors (educational attainment, prepregnancy smoking rate, and delay discounting [DD]) of spontaneous quitting among pregnant smokers. These predictors were examined alone and in combination with other potential predictors using study-intake assessments from controlled clinical trials examining the efficacy of financial incentives for smoking cessation and relapse prevention. Data from 349 pregnant women (231 continuing smokers and 118 spontaneous quitters) recruited from the greater Burlington, VT, area contributed to this secondary analysis, including psychiatric/sociodemographic characteristics, smoking characteristics, and performance on a computerized DD task. Educational attainment, smoking rate, and DD values were each significant predictors of spontaneous quitting in univariate analyses. A model examining those three predictors together retained educational attainment as a main effect and revealed a significant interaction of DD and smoking rate (i.e., DD was a significant predictor at lower but not higher smoking rates). A final model considering all potential predictors, included education, the interaction of DD and smoking rate, and five additional predictors (i.e., stress ratings, the belief that smoking during pregnancy will "greatly harm my baby," age of smoking initiation, marital status, and prior quit attempts during pregnancy). The study presented here contributes new knowledge on predictors of spontaneous quitting among pregnant smokers with substantive practical implications for reducing smoking during pregnancy.
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Affiliation(s)
- Thomas J. White
- Vermont Center on Behavior & Health, University of Vermont
- Department of Psychiatry, University of Vermont
| | - Ryan Redner
- Vermont Center on Behavior & Health, University of Vermont
- Department of Psychiatry, University of Vermont
| | - Joan M. Skelly
- Department of Medical Biostatistics, University of Vermont
| | - Stephen T. Higgins
- Vermont Center on Behavior & Health, University of Vermont
- Department of Psychiatry, University of Vermont
- Department of Psychology University of Vermont
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158
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Park BY, Lee BK. Use of meconium in perinatal epidemiology: potential benefits and pitfalls. Ann Epidemiol 2014; 24:878-81. [PMID: 25444889 DOI: 10.1016/j.annepidem.2014.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/12/2014] [Accepted: 09/15/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE Meconium is a biomarker matrix that can be used to assess cumulative exposures in epidemiologic studies of prenatal risk factors. Depending on when meconium is collected, different exposure windows during pregnancy can be measured. However, little guidance exists regarding the extent to which timing of meconium collection will influence resulting effect estimates. METHODS We performed a simulation study of prenatal tobacco smoke exposure (assessed from meconium nicotine) and birth weight. We discuss four typical meconium collection methods capturing different exposure windows and assess the biases induced by these methods. RESULTS In simulations assuming that exposure to tobacco smoke only during late gestation was of etiologic relevance to birth weight, use of a meconium collection method that captured exposure windows other than late gestation resulted in biased estimates of the true nicotine-birth weight association. CONCLUSIONS Using meconium collection methods that do not reflect an exposure window of etiologic relevance can lead to biased results and erroneous conclusions regarding the nature of prenatal exposure-outcome associations. Understanding how prenatal exposure patterns vary across the pregnancy and exposure windows of etiologic relevance is essential in determining when and how to collect meconium for use in biomarker studies of prenatal exposure.
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Affiliation(s)
- Bo Y Park
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA.
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA
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159
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Tobacco use in pregnant women: analysis of data from Demographic and Health Surveys from 54 low-income and middle-income countries. LANCET GLOBAL HEALTH 2014; 2:e513-e520. [DOI: 10.1016/s2214-109x(14)70283-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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160
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Ohrling H, Törring O, Yin L, Iliadou AN, Tullgren O, Abraham-Nordling M, Wallin G, Hall P, Lönn S. Decreased birth weight, length, and head circumference in children born by women years after treatment for hyperthyroidism. J Clin Endocrinol Metab 2014; 99:3217-23. [PMID: 24878049 DOI: 10.1210/jc.2014-1168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Whether hyperthyroidism influences the birth characteristics of children born several years after treatment is unknown. OBJECTIVE The objective of the study was to compare birth characteristics in singleton newborns delivered by women previously treated for Graves' disease (GD), toxic nodular goiter (TNG), or nontoxic goiter (NTG). DESIGN This was a nested case-control design within a national cohort registry study from 1950 through 2006. SETTING The study was conducted at a university and a hospital center in collaboration. PATIENTS The birth characteristics of newborns (n = 3421) delivered in a cohort of 43 633 women treated for GD or toxic nodular goiter by radioiodine or surgery (exposed group) at least 1 year prior to pregnancy were compared with newborns (n = 2914) of 45 655 mothers, previously operated for NTG (unexposed group). MAIN OUTCOME The primary outcome was birth weight, length, and head circumference. The secondary outcome was malformations, gestational age, and type of hyperthyroidism. RESULTS The birth weight of exposed children was 3431 ± 607 g (mean ± SD) compared with the unexposed, 3520 ± 641 g (P < .001). The cumulative odds ratio (OR) for lower birth weight was 1.29 [95% confidence interval (CI) 1.16-1.43]. The average birth length for the exposed children was 50.0 ± 2.7 cm compared with the unexposed of 50.4 cm ± 2.6 cm (P < .01) [cumulative OR 1.25 (95% CI 1.13-1.37)]. The head circumference was 34.5 ± 1.9 cm among exposed and 34.7 ± 1.8 cm, respectively (P < .001), with an OR of 1.24 (95% CI 1.13-1.35). No differences in birth characteristics were observed between children born after maternal GD or toxic nodular goiter. CONCLUSIONS Previous GD or TNG may influence the birth characteristics several years after radioiodine or surgical treatment.
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Affiliation(s)
- Hans Ohrling
- Division of Endocrinology (H.O., O.Tö.), Department of Internal Medicine, Södersjukhuset, 11883, Stockholm, Sweden; Institution of Clinical Research and Education (O.Tö.), Department of Medical Epidemiology and Biostatistics (L.Y., A.N.I., P.H., S.L.), and Institution of Molecular Medicine and Surgery (M.A.-N., G.W.), Karolinska Institutet, 17177, Stockholm, Sweden; Department of Oncology (O.Tu.), Karolinska University Hospital, 171 76 Solna, Sweden; and Department of Research and Development (S.L.), Region Halland, 301 80 Halmstad, Sweden
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161
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Rydbeck F, Rahman A, Grandér M, Ekström EC, Vahter M, Kippler M. Maternal urinary iodine concentration up to 1.0 mg/L is positively associated with birth weight, length, and head circumference of male offspring. J Nutr 2014; 144:1438-44. [PMID: 25031330 DOI: 10.3945/jn.114.193029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Adequate iodine status in early life is crucial for neurodevelopment. However, little is known about the effects of maternal iodine status during pregnancy on fetal growth. The present study investigated the potential impact of maternal iodine status during pregnancy on offspring birth size. This large prospective cohort study was nested in a Bangladeshi population-based randomized supplementation trial in pregnant women [MINIMat (Maternal and Infant Nutrition Interventions in Matlab)]. Urine samples obtained at 8 wk of gestation from 1617 women were analyzed for iodine and other elements, such as arsenic and cadmium, using inductively coupled plasma mass spectrometry. Anthropometric measurements at birth included weight, length, and head and chest circumference. Maternal urinary iodine concentrations (UICs) ranged from 0.020 to 10 mg/L, with a median of 0.30 mg/L. Below ∼1.0 mg/L, UIC was significantly positively associated with birth weight and length. Birth weight and length increased by 9.3 g (95% CI: 2.9, 16) and 0.042 cm (95% CI: 0.0066, 0.076), respectively, for each 0.1-mg/L increase in maternal UIC. No associations were observed between UIC and head or chest circumference. When we stratified the analyses by newborn sex, the positive associations between maternal UIC (<1 mg/L) and measurements of size at birth were restricted to boys, with no evidence in girls. Among boys, the mean weight, length, and head circumference increased by 70 g (P = 0.019), 0.41 cm (P = 0.013), and 0.28 cm (P = 0.031) for every 0.5-mg/L increase in maternal UIC. Maternal iodine status was positively associated with weight, length, and head circumference in boys up to ∼1 mg/L, which is well above the recommended maximum concentration of 0.5 mg/L. The associations leveled off at UIC ≥ 1 mg/L. Our findings support previous conclusions that the advantages of correcting potential iodine deficiency outweigh the risks of excess exposure.
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Affiliation(s)
- Filip Rydbeck
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anisur Rahman
- Centre for Reproductive Health, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; and
| | - Margaretha Grandér
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Eva-Charlotte Ekström
- Department of Women's and Children's Health, International Maternal and Child Health, University Hospital, Uppsala, Sweden
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden;
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162
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Krstev S, Marinković J, Simić S, Kocev N, Bondy SJ. The influence of maternal smoking and exposure to residential ETS on pregnancy outcomes: a retrospective national study. Matern Child Health J 2014; 17:1591-8. [PMID: 23090285 DOI: 10.1007/s10995-012-1169-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In a nationwide study of Serbian births, in 2008, we estimated the influence of maternal prenatal smoking and environmental tobacco smoke (ETS) exposure on birth outcomes. Using stratified two-stage random cluster sampling, 2,721 women were interviewed in-person (response rates 98.1 %), and 2,613 singleton live births were included. Date of birth, gender, birthweight, birth height and head circumference were copied from the official hospital Birth Certificate. Six exposure categories were defined according to mother's smoking history and exposure to ETS. We calculated adjusted mean values and group differences by analysis of covariance, and adjusted odds ratios for the low birthweight (LBW < 2,500 g). Compared to the reference category (non-smoking, non-exposed to ETS) we observed birthweight reductions in infants whose mothers smoked continuously during the pregnancy and were exposed to ETS (-162.6 g) and whose mothers were not exposed to ETS (-173 g) (p = 0.000, and p = 0.003, respectively), as well as reduction in birth length (-1.01 and -1.06 cm; p = 0.003 and p = 0.000, respectively). Reduction in birthweight and birth length related to exposure categories was not linear. Adjusted OR for LBW was almost tripled for mothers who smoked over the entire pregnancy and were non-exposed to ETS (aOR 2.85; 95 % CI 1.46-5.08), and who were exposed to ETS (aOR 2.68; 95 % CI 1.15-6.25). Our results showed strong effects of smoking throughout the pregnancy on reduced birthweight, birth length and head circumference, and increased risk for LBW. We were not able to detect an effect for ETS exposure alone.
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Affiliation(s)
- Srmena Krstev
- Serbian Institute of Occupational Health "Dr. Dragomir Karajovic", Deligradska 29, 11 000, Belgrade, Serbia,
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163
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Leite M, Albieri V, Kjaer SK, Jensen A. Maternal smoking in pregnancy and risk for congenital malformations: results of a Danish register-based cohort study. Acta Obstet Gynecol Scand 2014; 93:825-34. [DOI: 10.1111/aogs.12433] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 05/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Mimmi Leite
- Virus, Lifestyle and Genes; Danish Cancer Society Research Centre; Copenhagen Denmark
| | - Vanna Albieri
- Statistics, Bioinformatics and Registry; Danish Cancer Society Research Centre; Copenhagen Denmark
| | - Susanne. K. Kjaer
- Virus, Lifestyle and Genes; Danish Cancer Society Research Centre; Copenhagen Denmark
- The Juliane Marie Centre; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Allan Jensen
- Virus, Lifestyle and Genes; Danish Cancer Society Research Centre; Copenhagen Denmark
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164
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Bacino CA, Hecht JT. Etiopathogenesis of equinovarus foot malformations. Eur J Med Genet 2014; 57:473-9. [PMID: 24932901 DOI: 10.1016/j.ejmg.2014.06.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/03/2014] [Indexed: 01/28/2023]
Abstract
Congenital talipes equinovarus (CTEV) is the most common musculoskeletal birth defect affecting approximately 1/700-1/1000 of liveborns. Even though extensive epidemiological and genetic studies have been carried out to address its causes, the precise mechanisms leading to this common birth defect remain elusive. CTEV is a multifactorial disorder, hence the combination of genetic and environmental factors are known contributors to this developmental abnormality. So far a handful of genes involved in limb patterning like PITX1, HOXA, HOXD, TBX4, and RBM10, as well as genes involved in muscle contraction, have been identified as possible players. Among many environmental factors investigated, maternal smoking seems to hold the strongest consistent association with this disorder. This article will review and discuss some of the most common genetic and environmental factors associated with the etiopathogenesis of CTEV.
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Affiliation(s)
- Carlos A Bacino
- Baylor College of Medicine, Department of Molecular and Human Genetics, Houston, TX, USA.
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165
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Margerison-Zilko C. Economic contraction and maternal health behaviors during pregnancy in a national sample of U.S. women. Ann Epidemiol 2014; 24:432-40. [PMID: 24703197 PMCID: PMC4029848 DOI: 10.1016/j.annepidem.2014.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 01/29/2014] [Accepted: 02/14/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study was to examine associations between maternal exposure to unexpected economic contraction and health behaviors during pregnancy using methods to account for impacts of economic contraction on selection into pregnancy. METHODS Data on health behaviors among 7074 pregnancies in the National Longitudinal Survey of Youth 1979 were linked to monthly unemployment rates in maternal state of residence. The study examined associations between exposure to unexpected economic contraction (higher than expected state-level unemployment) during each trimester of pregnancy and maternal smoking, alcohol use, and gestational weight gain using generalized linear models. RESULTS Economic contraction was not associated with maternal smoking or gestational weight gain. Associations between economic contraction and maternal alcohol use differed by maternal race-ethnicity and education. Among black-non-Hispanic women, exposures to economic contraction during the first and second trimester of pregnancy were associated with a 42% (95% confidence interval, 1.08, 1.85) and 33% (95% confidence interval, 1.01, 1.74) increased risk of alcohol use, respectively. CONCLUSIONS Findings suggest that exposure to extreme economic contraction during pregnancy may be associated with increased use of alcohol with differences by maternal race-ethnicity and educational attainment. Economic contraction was not associated with other maternal pregnancy behaviors.
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Prenatal and Postpartum Care of Women with Substance Use Disorders. Obstet Gynecol Clin North Am 2014; 41:213-28. [DOI: 10.1016/j.ogc.2014.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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167
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Vogelgesang A, Scapin C, Barone C, Tam E, Blumental Perry A, Dammann CEL. Cigarette smoke exposure during pregnancy alters fetomaternal cell trafficking leading to retention of microchimeric cells in the maternal lung. PLoS One 2014; 9:e88285. [PMID: 24832066 PMCID: PMC4022454 DOI: 10.1371/journal.pone.0088285] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 01/07/2014] [Indexed: 01/09/2023] Open
Abstract
Cigarette smoke exposure causes chronic oxidative lung damage. During pregnancy, fetal microchimeric cells traffic to the mother. Their numbers are increased at the site of acute injury. We hypothesized that milder chronic diffuse smoke injury would attract fetal cells to maternal lungs. We used a green-fluorescent-protein (GFP) mouse model to study the effects of cigarette smoke exposure on fetomaternal cell trafficking. Wild-type female mice were exposed to cigarette smoke for about 4 weeks and bred with homozygote GFP males. Cigarette smoke exposure continued until lungs were harvested and analyzed. Exposure to cigarette smoke led to macrophage accumulation in the maternal lung and significantly lower fetal weights. Cigarette smoke exposure influenced fetomaternal cell trafficking. It was associated with retention of GFP-positive fetal cells in the maternal lung and a significant reduction of fetal cells in maternal livers at gestational day 18, when fetomaternal cell trafficking peaks in the mouse model. Cells quickly clear postpartum, leaving only a few, difficult to detect, persisting microchimeric cells behind. In our study, we confirmed the postpartum clearance of cells in the maternal lungs, with no significant difference in both groups. We conclude that in the mouse model, cigarette smoke exposure during pregnancy leads to a retention of fetal microchimeric cells in the maternal lung, the site of injury. Further studies will be needed to elucidate the effect of cigarette smoke exposure on the phenotypic characteristics and function of these fetal microchimeric cells, and confirm its course in cigarette smoke exposure in humans.
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Affiliation(s)
- Anja Vogelgesang
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, United States of America
- Hanover Medical School, Hanover, Germany
| | - Cristina Scapin
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, United States of America
- Genetic and Cellular Biology Division, Dibit. San Raffaele Scientific Institute, Milan, Italy
| | - Caroline Barone
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Elaine Tam
- Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Anna Blumental Perry
- Department of Surgery, Tufts Medical Center, Boston, Massachusetts, United States of America
- Department of Biomedical Sciences, Mercer School of Medicine and Department of Laboratory Oncology Research, Anderson Cancer Institute, Memorial University Medical Center, Savannah, Georgia, United States of America
| | - Christiane E. L. Dammann
- Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts, United States of America
- Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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168
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Smokeless tobacco use in pregnancy: an integrative review of the literature. Int J Public Health 2014; 59:599-608. [PMID: 24794708 DOI: 10.1007/s00038-014-0558-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 04/14/2014] [Accepted: 04/16/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To systematically critique and summarise the available evidence on the outcomes of smokeless tobacco use in pregnancy to inform the public health response. METHODS In March 2013, a search was conducted of observational studies where the exposure to smokeless tobacco during pregnancy and maternal, placental and/or neonatal outcomes was assessed. Two reviewers extracted data and completed quality assessment of the literature utilizing the Agency for Healthcare Research and Quality criteria (West et al. 2002). RESULTS The search resulted in 211 articles, 21 (10%) of which met the final criteria for integrative review. Ten (10) of the studies are from India, seven (7) from Sweden, two (2) from Alaska and one (1) each from South Africa and Pakistan. CONCLUSIONS Many studies lacked sufficient power to estimate precise risks. Most reports were hindered by imprecise measures of exposure and lack of confounding variable control. However, there were indications that maternal smokeless tobacco use increases rates of stillbirth, low birth weight and alters the male:female live birth ratio. Maternal smokeless tobacco use may not be safe for mother or foetus.
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169
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Mumford EA, Hair EC, Yu TC, Liu W. Women’s longitudinal smoking patterns from preconception through child’s kindergarten entry: profiles of biological mothers of a 2001 US birth cohort. Matern Child Health J 2014; 18:810-20. [PMID: 23797269 PMCID: PMC3858416 DOI: 10.1007/s10995-013-1305-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To identify longitudinal patterns of women’s smoking during the pre-conception, perinatal, and early parenting period and describe risk factors distinguishing the different profiles. We conducted longitudinal latent class analysis of maternal smoking status over a 6–7 year period in a sample of 8,650 biological mothers of the Early Childhood Longitudinal Study-Birth Cohort, nationally representative of US births in 2001. Five latent classes were identified: pregnancy-inspired quitters (4.3 %), delayed initiators (5.1 %), persistent smokers (8.5 %), temporary quitters (10.4 %), and nonsmokers (71.7 %). These classes were distinguished by age, race/ethnicity, education, poverty status, marital status, parity, drinking behavior, and depression. For example, when compared to those with college degrees, those with less than a high school degree were at least five times as likely to be in the delayed initiator, temporary quitter, or persistent smoker classes (vs. the nonsmoker class). Heterogeneous longitudinal smoking patterns indicate the need for both prevention messages and cessation treatment continuing past parturition, tailored to fit individual profiles in order to achieve better health outcomes for both mothers and children.
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Affiliation(s)
- Elizabeth A. Mumford
- Senior Research Scientist, NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD 20814, Telephone: (301) 634- 9435 Fax: (301) 634-9301
| | - Elizabeth C. Hair
- Senior Research Scientist, NORC at the University of Chicago, Telephone: (301) 634-9386
| | - Tzy-Chyi Yu
- Research Scientist, NORC at the University of Chicago, Telephone: (301) 634-9513
| | - Weiwei Liu
- Research Scientist, NORC at the University of Chicago, Telephone: (301) 634-9559
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El Marroun H, Schmidt MN, Franken IHA, Jaddoe VWV, Hofman A, van der Lugt A, Verhulst FC, Tiemeier H, White T. Prenatal tobacco exposure and brain morphology: a prospective study in young children. Neuropsychopharmacology 2014; 39:792-800. [PMID: 24096296 PMCID: PMC3924517 DOI: 10.1038/npp.2013.273] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 08/01/2013] [Accepted: 09/20/2013] [Indexed: 11/09/2022]
Abstract
It is well known that smoking during pregnancy can affect offspring health. Prenatal tobacco exposure has been associated with negative behavioral and cognitive outcomes in childhood, adolescence, and young adulthood. These associations between prenatal tobacco exposure and psychopathology in offspring could possibly be explained by the influence of prenatal tobacco exposure on brain development. In this prospective study, we investigated the association between prenatal tobacco exposure, behavioral and emotional functioning and brain morphology in young children. On the basis of age and gender, we matched 113 children prenatally exposed to tobacco with 113 unexposed controls. These children were part of a population-based study in the Netherlands, the Generation R Study, and were followed from pregnancy onward. Behavioral and emotional functioning was assessed at age 6 with the Child Behavior Checklist. We assessed brain morphology using magnetic resonance imaging techniques in children aged 6-8 years. Children exposed to tobacco throughout pregnancy have smaller total brain volumes and smaller cortical gray matter volumes. Continued prenatal tobacco exposure was associated with cortical thinning, primarily in the superior frontal, superior parietal, and precentral cortices. These children also demonstrated increased scores of affective problems. In addition, thickness of the precentral and superior frontal cortices was associated with affective problems. Importantly, brain development in offspring of mothers who quit smoking during pregnancy resembled that of nonexposed controls (no smaller brain volumes and no thinning of the cortex). Our findings suggest an association between continued prenatal tobacco exposure and brain structure and function in school-aged children.
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Affiliation(s)
- Hanan El Marroun
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Marcus N Schmidt
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
| | - Ingmar H A Franken
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
- Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands
- The Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands
- The Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Albert Hofman
- The Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Aad van der Lugt
- The Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Frank C Verhulst
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Henning Tiemeier
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
- The Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- The Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Tonya White
- The Department of Child and Adolescent Psychiatry, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
- The Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
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Hyland A, Piazza KM, Hovey KM, Ockene JK, Andrews CA, Rivard C, Wactawski-Wende J. Associations of lifetime active and passive smoking with spontaneous abortion, stillbirth and tubal ectopic pregnancy: a cross-sectional analysis of historical data from the Women's Health Initiative. Tob Control 2014; 24:328-35. [PMID: 24572626 DOI: 10.1136/tobaccocontrol-2013-051458] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/07/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the associations between tobacco exposure and adverse pregnancy outcomes using quantitative measures of lifetime active smoking and secondhand smoke (SHS) exposure. METHODS Historical reproductive data on 80 762 women who participated in the Women's Health Initiative Observational Study were examined with a cross-sectional analysis. We assessed self-reported lifetime active and passive tobacco smoke exposure, self-reported spontaneous abortions, stillbirths and ectopic pregnancies. RESULTS When compared with never-smoking women, participants who were ever active smokers during their reproductive years had ORs (OR) of 1.16 (95% CI 1.08 to 1.26) for 1 or more spontaneous abortions, 1.44 (95% CI 1.20 to 1.73) for 1 or more stillbirths, and 1.43 (95% CI 1.10 to 1.86) for 1 or more ectopic pregnancies. Never-smoking women participants with the highest levels of lifetime SHS exposure, including childhood >10 years, adult home >20 years and adult work exposure >10 years, when compared with never-smoking women with no SHS exposure had adjusted ORs of 1.17 (95% CI 1.05 to 1.30) for spontaneous abortion, 1.55 (95% CI 1.21 to 1.97) for stillbirth, and 1.61 (95% CI 1.16 to 2.24) for ectopic pregnancy. CONCLUSIONS Women who were ever-smokers during their reproductive years had significantly greater estimates of risk for spontaneous abortion, stillbirth and tubal ectopic pregnancy. Never-smoking women with the highest levels of lifetime exposure to SHS had significantly increased estimates of risk for spontaneous abortion, stillbirth and tubal ectopic pregnancy.
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Affiliation(s)
- Andrew Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Buffalo, Roswell Park Cancer Institute, New York, USA
| | - Kenneth M Piazza
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Buffalo, Roswell Park Cancer Institute, New York, USA
| | - Kathleen M Hovey
- Department of Social & Preventive Medicine, University at Buffalo School of Public Health & Health Professions, Buffalo, New York, USA
| | - Judith K Ockene
- Division of Preventive & Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Christopher A Andrews
- University at Buffalo School of Public Health & Health Professions, Department of Biostatistics, Buffalo, New York, USA
| | - Cheryl Rivard
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Buffalo, Roswell Park Cancer Institute, New York, USA
| | - Jean Wactawski-Wende
- Department of Social & Preventive Medicine, University at Buffalo School of Public Health & Health Professions, Buffalo, New York, USA
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172
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Hardy B, Szatkowski L, Tata LJ, Coleman T, Dhalwani NN. Smoking cessation advice recorded during pregnancy in United Kingdom primary care. BMC FAMILY PRACTICE 2014; 15:21. [PMID: 24484239 PMCID: PMC3930304 DOI: 10.1186/1471-2296-15-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 01/10/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND United Kingdom (UK) national guidelines recommend that all pregnant women who smoke should be advised to quit at every available opportunity, and brief cessation advice is an efficient and cost-effective means to increase quit rates. The Quality and Outcomes Framework (QOF) implemented in 2004 requires general practitioners to document their delivery of smoking cessation advice in patient records. However, no specific targets have been set in QOF for the recording of this advice in pregnant women. We used a large electronic primary care database from the UK to quantify the pregnancies in which women who smoked were recorded to have been given smoking cessation advice, and the associated maternal characteristics. METHODS Using The Health Improvement Network database we calculated annual proportions of pregnant smokers between 2000 and 2009 with cessation advice documented in their medical records during pregnancy. Logistic regression was used to assess variation in the recording of cessation advice with maternal characteristics. RESULTS Among 45,296 pregnancies in women who smoked, recorded cessation advice increased from 7% in 2000 to 37% in 2004 when the QOF was introduced and reduced slightly to 30% in 2009. Pregnant smokers from the youngest age group (15-19) were 21% more likely to have a record of cessation advice compared to pregnant smokers aged 25-29 (OR 1.21, 95% CI 1.10-1.35) and pregnant smokers from the most deprived group were 38% more likely to have a record for cessation advice compared to pregnant smokers from the least deprived group (OR 1.38, 95% CI 1.14-1.68). Pregnant smokers with asthma were twice as likely to have documentation of cessation advice in their primary care records compared to pregnant smokers without asthma (OR 1.97, 95% CI 1.80-2.16). Presence of comorbidities such as diabetes, hypertension and mental illness also increased the likelihood of having smoking cessation advice recorded. No marked variations were observed in the recording of cessation advice with body mass index. CONCLUSION Recorded delivery of smoking cessation advice for pregnant smokers in primary care has increased with some fluctuation over the years, especially after the implementation of the QOF, and varies with maternal characteristics.
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Affiliation(s)
| | | | | | | | - Nafeesa N Dhalwani
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1 PB, UK.
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Sieminska A, Jassem E. The many faces of tobacco use among women. Med Sci Monit 2014; 20:153-62. [PMID: 24487778 PMCID: PMC3915001 DOI: 10.12659/msm.889796] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 10/21/2013] [Indexed: 12/14/2022] Open
Abstract
Smoking is still considered to be mainly a male problem. However, it is estimated that there are approximately 250 million women worldwide who smoke cigarettes and millions more women who use smokeless tobacco products. This article addresses the many facets of tobacco use among women. The aim of the paper is to increase recognition among clinicians and researchers of the specific characteristics of female tobacco use. Together with providing epidemiological data on the distribution of tobacco use among women and data from population-based analyses on sociocultural factors that influence it, the article presents tobacco use during pregnancy as a particularly important public health problem. Further, the article points out sex-related differences (ie, physiological, psychological, or behavioral) between male and female tobacco use. A special focus is on the important role of ovarian hormones. Adverse effects of tobacco use to women and their children as well as tobacco-related morbidities and comorbidities are presented, and women's greater susceptibility to tobacco constituents as compared to men is stressed. Awareness of these differences can contribute to improvement of the effectiveness of smoking cessation programs addressed both to the specific female population and to an individual smoking woman.
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Melo M, Bellver J, Soares SR. The impact of cigarette smoking on the health of descendants. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.12.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Płotka J, Narkowicz S, Polkowska Z, Biziuk M, Namieśnik J. Effects of addictive substances during pregnancy and infancy and their analysis in biological materials. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2014; 227:55-77. [PMID: 24158579 DOI: 10.1007/978-3-319-01327-5_2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The use of addictive substances during pregnancy is a serious social problem, not only because of effects on the health of the woman and child, but also because drug or alcohol dependency detracts from child care and enhances the prospect of child neglect and family breakdown. Developing additive substance abuse treatment programs for pregnant women is socially important and can help ensure the health of babies, prevent subsequent developmental and behavioral problems (i.e., from intake of alcohol or other additive substances such as methamphetamine, cocaine,or heroine) and can reduce addiction costs to society. Because women of childbearing age often abuse controlled substances during their pregnancy, it is important to undertake biomonitoring of these substances in biological samples taken from the pregnant or nursing mother (e.g., blood, urine,hair, breast milk, sweat, oral fluids, etc.), from the fetus and newborn (e.g., meconium,cord blood, neonatal hair and urine) and from both the mother and fetus (i.e.,amniotic fluids and placenta). The choice of specimens to be analyzed is determined by many factors; however, the most important is knowledge of the chemical and physical characteristics of a substance and the route of it administration. Maternal and neonatal biological materials reflect exposures that occur over a specific time period, and each of these biological specimens has different advantages and disadvantages,in terms of accuracy, time window of exposure and cost/benefit ratio.Sampling the placenta may be the most important biomonitoring choice for assessing in utero exposure to addictive substances. The use of the placenta in scientific research causes a minimum of ethical problems, partly because its sampling is noninvasive, causes no harm to mother or child, and partly because, in any case,placentas are discarded and incinerated after birth. Such samples, when properly analyzed, may provide key essential information about fetal exposure to toxic substances, and may provide the groundwork for protecting the fetus or newborn and the mother from further damage.Several sensitive and specific bioanalytical methods are commonly utilized to accurately measure for drug biomarkers of in utero drug exposure. Moreover, several immunoassay methods are used to rapidly screen for drugs in many biological specimen types. However, results from immunoassays should be carefully interpreted,and should be confirmed by more specific and sensitive chromatographic methods, such as GC-MS or LC-MS. Although techniques for analysis of addictive substances are still being developed or are being refined, current methods are efficient and sensitive and provide valuable information on human exposures to addictive substances and their metabolites.
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Affiliation(s)
- Justyna Płotka
- Department of Analytical Chemistry, Chemical Faculty, Gdansk University of Technology (GUT), 11/12 Narutowicza Street, 80-233, Gdańsk, Poland,
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Fetal and neonatal exposure to nicotine leads to augmented hepatic and circulating triglycerides in adult male offspring due to increased expression of fatty acid synthase. Toxicol Appl Pharmacol 2013; 275:1-11. [PMID: 24368177 DOI: 10.1016/j.taap.2013.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/09/2013] [Accepted: 12/12/2013] [Indexed: 12/25/2022]
Abstract
While nicotine replacement therapy is assumed to be a safer alternative to smoking during pregnancy, the long-term consequences for the offspring remain elusive. Animal studies now suggest that maternal nicotine exposure during perinatal life leads to a wide range of adverse outcomes for the offspring including increased adiposity. The focus of this study was to investigate if nicotine exposure during pregnancy and lactation leads to alterations in hepatic triglyceride synthesis. Female Wistar rats were randomly assigned to receive daily subcutaneous injections of saline (vehicle) or nicotine bitartrate (1mg/kg/day) for two weeks prior to mating until weaning. At postnatal day 180 (PND 180), nicotine exposed offspring exhibited significantly elevated levels of circulating and hepatic triglycerides in the male offspring. This was concomitant with increased expression of fatty acid synthase (FAS), the critical hepatic enzyme in de novo triglyceride synthesis. Given that FAS is regulated by the nuclear receptor Liver X receptor (LXRα), we measured LXRα expression in both control and nicotine-exposed offspring. Nicotine exposure during pregnancy and lactation led to an increase in hepatic LXRα protein expression and enriched binding to the putative LXRE element on the FAS promoter in PND 180 male offspring. This was also associated with significantly enhanced acetylation of histone H3 [K9,14] surrounding the FAS promoter, a hallmark of chromatin activation. Collectively, these findings suggest that nicotine exposure during pregnancy and lactation leads to an increase in circulating and hepatic triglycerides long-term via changes in the transcriptional and epigenetic regulation of the hepatic lipogenic pathway.
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Alzeidan RA, Mandil AA, Fayed AA, Wahabi HA. The effectiveness of breath carbon monoxide analyzer in screening for environmental tobacco smoke exposure in Saudi pregnant women. Ann Thorac Med 2013; 8:214-7. [PMID: 24250735 PMCID: PMC3821281 DOI: 10.4103/1817-1737.118505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 05/24/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Exposure to environmental tobacco smoke (ETS) has harmful effects on the pregnancy outcomes similar to those observed in actively smoking pregnant women. The aim of this study was to estimate the sensitivity and specificity of the breath carbon monoxide (BCO) analysis in the assessment of smoking status among Saudi pregnant women, including ETS exposure compared to self-reported tobacco smoke exposure. METHODS: A cross-sectional design was used during January 2012, 560 pregnant women, irrespective of their gestational age, agreed to undergo BCO testing and completed the data collection sheet for the study. Sensitivity, specificity, positive and negative predictive values were calculated to compare the BCO test with self-reported exposure to ETS. RESULTS: Of the study population 151 (27%) women self-reported ETS exposure during the index pregnancy, 409 (73%) self-reported non-exposure. Sensitivity of the test was 32.5% (95% CI; 25.2-40.3%), the Specificity was much higher at 69.2% (95% CI; 64.4-73.5%), the positive predictive value was 28% (95% CI, 21.9-35.1%), and the negative predictive value was 73.5% (95% CI; 68.9-77.7%). CONCLUSION: The BCO test is an ineffective tool to detect the level of ETS exposure among Saudi pregnant women.
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Affiliation(s)
- Rasmieh Ayed Alzeidan
- Sheikh Bahamdan Research Chair of Evidence-based Healthcare and Knowledge Translation, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Chamberlain C, O’Mara-Eves A, Oliver S, Caird JR, Perlen SM, Eades SJ, Thomas J. Psychosocial interventions for supporting women to stop smoking in pregnancy. Cochrane Database Syst Rev 2013; 10:CD001055. [PMID: 24154953 PMCID: PMC4022453 DOI: 10.1002/14651858.cd001055.pub4] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tobacco smoking in pregnancy remains one of the few preventable factors associated with complications in pregnancy, stillbirth, low birthweight and preterm birth and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and increasing in low- to middle-income countries. OBJECTIVES To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. SEARCH METHODS In this fifth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 March 2013), checked reference lists of retrieved studies and contacted trial authors to locate additional unpublished data. SELECTION CRITERIA Randomised controlled trials, cluster-randomised trials, randomised cross-over trials, and quasi-randomised controlled trials (with allocation by maternal birth date or hospital record number) of psychosocial smoking cessation interventions during pregnancy. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, and subgroup analyses and sensitivity analysis were conducted in SPSS. MAIN RESULTS Eighty-six trials were included in this updated review, with 77 trials (involving over 29,000 women) providing data on smoking abstinence in late pregnancy.In separate comparisons, counselling interventions demonstrated a significant effect compared with usual care (27 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.75), and a borderline effect compared with less intensive interventions (16 studies; average RR 1.35, 95% CI 1.00 to 1.82). However, a significant effect was only seen in subsets where counselling was provided in conjunction with other strategies. It was unclear whether any type of counselling strategy is more effective than others (one study; RR 1.15, 95% CI 0.86 to 1.53). In studies comparing counselling and usual care (the largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy (eight studies; average RR 1.06, 95% CI 0.93 to 1.21). However, a clear effect was seen in smoking abstinence at zero to five months postpartum (10 studies; average RR 1.76, 95% CI 1.05 to 2.95), a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77), and a significant effect at 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), but not in the longer term. In other comparisons, the effect was not significantly different from the null effect for most secondary outcomes, but sample sizes were small.Incentive-based interventions had the largest effect size compared with a less intensive intervention (one study; RR 3.64, 95% CI 1.84 to 7.23) and an alternative intervention (one study; RR 4.05, 95% CI 1.48 to 11.11).Feedback interventions demonstrated a significant effect only when compared with usual care and provided in conjunction with other strategies, such as counselling (two studies; average RR 4.39, 95% CI 1.89 to 10.21), but the effect was unclear when compared with a less intensive intervention (two studies; average RR 1.19, 95% CI 0.45 to 3.12).The effect of health education was unclear when compared with usual care (three studies; average RR 1.51, 95% CI 0.64 to 3.59) or less intensive interventions (two studies; average RR 1.50, 95% CI 0.97 to 2.31).Social support interventions appeared effective when provided by peers (five studies; average RR 1.49, 95% CI 1.01 to 2.19), but the effect was unclear in a single trial of support provided by partners.The effects were mixed where the smoking interventions were provided as part of broader interventions to improve maternal health, rather than targeted smoking cessation interventions.Subgroup analyses on primary outcome for all studies showed the intensity of interventions and comparisons has increased over time, with higher intensity interventions more likely to have higher intensity comparisons. While there was no significant difference, trials where the comparison group received usual care had the largest pooled effect size (37 studies; average RR 1.34, 95% CI 1.25 to 1.44), with lower effect sizes when the comparison group received less intensive interventions (30 studies; average RR 1.20, 95% CI 1.08 to 1.31), or alternative interventions (two studies; average RR 1.26, 95% CI 0.98 to 1.53). More recent studies included in this update had a lower effect size (20 studies; average RR 1.26, 95% CI 1.00 to 1.59), I(2)= 3%, compared to those in the previous version of the review (50 studies; average RR 1.50, 95% CI 1.30 to 1.73). There were similar effect sizes in trials with biochemically validated smoking abstinence (49 studies; average RR 1.43, 95% CI 1.22 to 1.67) and those with self-reported abstinence (20 studies; average RR 1.48, 95% CI 1.17 to 1.87). There was no significant difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however the effect was unclear in three dissemination trials of counselling interventions where the focus on the intervention was at an organisational level (average RR 0.96, 95% CI 0.37 to 2.50). The pooled effects were similar in interventions provided for women with predominantly low socio-economic status (44 studies; average RR 1.41, 95% CI 1.19 to 1.66), compared to other women (26 studies; average RR 1.47, 95% CI 1.21 to 1.79); though the effect was unclear in interventions among women from ethnic minority groups (five studies; average RR 1.08, 95% CI 0.83 to 1.40) and aboriginal women (two studies; average RR 0.40, 95% CI 0.06 to 2.67). Importantly, pooled results demonstrated that women who received psychosocial interventions had an 18% reduction in preterm births (14 studies; average RR 0.82, 95% CI 0.70 to 0.96), and infants born with low birthweight (14 studies; average RR 0.82, 95% CI 0.71 to 0.94). There did not appear to be any adverse effects from the psychosocial interventions, and three studies measured an improvement in women's psychological wellbeing. AUTHORS' CONCLUSIONS Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy, and reduce low birthweight and preterm births.
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Affiliation(s)
- Catherine Chamberlain
- Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alison O’Mara-Eves
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Sandy Oliver
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Jenny R Caird
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
| | - Susan M Perlen
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Sandra J Eades
- School of Public Health, Sydney School of Medicine, University of Sydney, Sydney, Australia
| | - James Thomas
- EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London, UK
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Talati A, Bao Y, Kaufman J, Shen L, Schaefer CA, Brown AS. Maternal smoking during pregnancy and bipolar disorder in offspring. Am J Psychiatry 2013; 170:1178-85. [PMID: 24084820 PMCID: PMC4086419 DOI: 10.1176/appi.ajp.2013.12121500] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Maternal smoking during pregnancy is associated with a number of adverse externalizing outcomes for offspring from childhood to adulthood. The relationship between maternal smoking and bipolar disorder in offspring, which includes externalizing symptoms among its many manifestations, has not been investigated in depth. The authors examined whether offspring exposed to maternal smoking in utero would be at increased lifetime risk for bipolar disorder after accounting for other factors related to maternal smoking. METHOD Individuals with bipolar disorder (N=79) were ascertained from the birth cohort of the Child Health and Development Study. Case subjects were identified by a combination of clinical, database, and direct mailing sources; all case subjects were directly interviewed and diagnosed using DSM-IV criteria. Comparison subjects (N=654) were matched to case subjects on date of birth (±30 days), sex, membership in the cohort at the time of illness onset, and availability of maternal archived sera. RESULTS After adjusting for potential confounders, offspring exposed to in utero maternal smoking exhibited a twofold greater risk for bipolar disorder (odds ratio=2.014, 95% confidence interval=1.48-2.53, p=0.01). The associations were noted primarily among bipolar offspring without psychotic features. CONCLUSIONS Prenatal tobacco exposure may be one suspected cause of bipolar disorder. However, it will be necessary to account for other unmeasured familial factors before causal teratogenic effects can be suggested.
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181
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Lurie S, Ribenzaft S, Boaz M, Golan A, Sadan O. The effect of cigarette smoking during pregnancy on mode of delivery in uncomplicated term singleton pregnancies. J Matern Fetal Neonatal Med 2013; 27:812-5. [PMID: 24020824 DOI: 10.3109/14767058.2013.842551] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the influence of cigarette smoking during pregnancy on mode of delivery. METHODS A retrospective analysis of 6105 uncomplicated term singleton pregnancies for mode of delivery was performed with respect to smoking status. RESULTS Of all, 680 (84.0%) smokers and 4588 (86.7%) non-smokers had a spontaneous vaginal delivery, 65 (8.0%) smokers and 393 (7.4%) non-smokers had an instrumental delivery and 65 (8.0%) smokers and 314 (5.9%) non-smokers had a cesarean delivery (p = 0.051). Smoking during pregnancy increased the risk of any operative or instrumental intervention by OR 1.240, 95% CI 1.012-1.523. Non-reassuring fetal heart rate pattern that warranted either cesarean or instrumental intervention was present in 99 (12.2%) out of 810 smokers and in 392 out of 5295 (7.4%) non-smokers, p < 0.001). Smoking during pregnancy increased the risk of non-reassuring fetal heart rate pattern that warranted either cesarean or instrumental intervention by OR 1.650 (95% CI 1.341-2.022). CONCLUSION Women with uncomplicated term singleton pregnancies who smoke during pregnancy are at an increased risk of fetal compromise during labor (as judged by non-reassuring fetal heart rate pattern), leading to increased rates of operative delivery (cesarean either instrumental).
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Affiliation(s)
- Samuel Lurie
- Department of Obstetrics and Gynecology, Edith Wolfson Medical Center , Holon , Israel
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182
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Investigation of the Alcohol, Smoking, and Substance Involvement Screening Test (the ASSIST) Version 3.0 in Pregnancy. ADDICTIVE DISORDERS & THEIR TREATMENT 2013. [DOI: 10.1097/adt.0b013e3182636904] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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183
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Park A, O'Malley SS, King SL, Picciotto MR. Mediating role of stress reactivity in the effects of prenatal tobacco exposure on childhood mental health outcomes. Nicotine Tob Res 2013; 16:174-85. [PMID: 23990474 DOI: 10.1093/ntr/ntt131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Prenatal tobacco exposure, through maternal smoking during pregnancy, has been associated with adverse mental health outcomes in childhood. However, the mechanisms by which prenatal tobacco exposure compromises mental health later in life are unclear. We hypothesized that sensitized reactivity to stressful life events in early childhood mediates the effect of prenatal tobacco exposure on mental health outcomes in middle childhood, after accounting for earlier mental health outcomes. METHODS Data were from 12,308 mothers and their children drawn from the Avon Longitudinal Study of Parents and Children, a large prospective population-based study. Mothers' self-reports of smoking during pregnancy, mothers' ratings of their child's reactivity to stressful life events, and teachers' and mothers' ratings of the Strengths and Difficulties Questionnaire assessing 5 domains of mental health outcomes were measured. RESULTS A positive association was found between prenatal tobacco exposure and stress reactivity between the ages of 2 and 6. In turn, stress reactivity was positively associated with peer (isolation), hyperactivity, conduct, and emotional problems (but not prosocial behaviors) between the ages of 7 and 11, after accounting for the mental health outcome at age 4 and other confounders. CONCLUSIONS Heightened stress reactivity in preschool ages mediated the effect of prenatal tobacco exposure on adverse mental health outcomes between the ages of 7 and 11. Interventions to assist children exposed to tobacco smoke during gestation in coping with stressful life events may help mitigate psychiatric symptoms in this population.
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Affiliation(s)
- Aesoon Park
- Department of Psychology, Syracuse University, NY
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184
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Jones HE, Heil SH, Tuten M, Chisolm MS, Foster JM, O Grady KE, Kaltenbach K. Cigarette smoking in opioid-dependent pregnant women: neonatal and maternal outcomes. Drug Alcohol Depend 2013; 131:271-7. [PMID: 23279924 PMCID: PMC3694998 DOI: 10.1016/j.drugalcdep.2012.11.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 11/19/2012] [Accepted: 11/23/2012] [Indexed: 01/12/2023]
Abstract
BACKGROUND The relationship between cigarette smoking and neonatal and maternal clinical outcomes among opioid-agonist-treated pregnant patients is sparse. OBJECTIVES (1) Is smoking measured at study entry related to neonatal and maternal outcomes in pregnant women receiving opioid-agonist medication? (2) Is it more informative to use a multi-item measure of smoking dependence or a single-item measure of daily smoking? (3) Is the relationship between smoking at study entry and outcomes different between methadone and buprenorphine? METHODS Secondary analyses examined the ability of the tobacco dependence screener (TDS) and self-reported past 30-day daily average number of cigarettes smoked, both measured at study entry, to predict 12 neonatal and 9 maternal outcomes in 131 opioid-agonist-maintained pregnant participants. RESULTS Past 30-day daily average number of cigarettes smoked was significantly positively associated with total amount of morphine (mg) needed to treat neonatal abstinence syndrome (NAS), Adjusted Odds Ratio (AOR)=1.06 (95% CI: 1.02, 1.09), number of days medicated for NAS, AOR=1.04 (95% CI: 1.01, 1.06), neonatal length of hospital stay in days, AOR=1.03 (95% CI: 1.01, 1.05), and negatively associated with 1-AOR=.995 (95% CI: .991,.999) and 5-min Apgar scores, AOR=.996 (95% CI: .994,.998). Simple effect tests of the two significant TDS×medication condition effects found TDS was unrelated to non-normal presentation and amount of voucher money earned in the methadone [AORs=.90 (95% CI: .74, 1.08, p>.24) and 1.0 (95% CI: .97, 1.03, p>.9)] but significant in the buprenorphine condition [AORs=1.57 (95% CI: 1.01, 2.45, p<.05) and 1.08 (95% CI: 1.04, 1.12, p<.01)]. CONCLUSIONS Regardless of prenatal methadone or buprenorphine exposure, heavier cigarette smoking was associated with more compromised birth outcomes.
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Affiliation(s)
- Hendrée E. Jones
- RTI International, Research Triangle Park, NC 27709 USA,Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA,Department of Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA
| | - Sarah H. Heil
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT 05401 USA
| | - Michelle Tuten
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA
| | - Margaret S. Chisolm
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21224 USA
| | | | - Kevin E. O Grady
- Department of Psychology, University of Maryland, College Park, College Park, MD 20742 USA
| | - Karol Kaltenbach
- Departments of Pediatrics and Psychiatry and Human Behavior, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107 USA
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The anti-apoptotic effect of hydrogen sulfide attenuates injuries to the medullary respiratory centers of neonatal rats subjected to in utero cigarette smoke exposure. Respir Physiol Neurobiol 2013; 188:29-38. [DOI: 10.1016/j.resp.2013.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/23/2013] [Accepted: 05/02/2013] [Indexed: 01/20/2023]
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186
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Han G, An L, Yang B, Si L, Zhang T. Nicotine-induced impairments of spatial cognition and long-term potentiation in adolescent male rats. Hum Exp Toxicol 2013; 33:203-13. [DOI: 10.1177/0960327113494902] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The aim of the present study was to investigate whether cognitive behavioral impairment, induced by nicotine in offspring rats, was associated with the alteration of hippocampal short-term potentiation (STP) and long-term potentiation (LTP) and to discuss the potential underlying mechanism. Young adult offspring rats were randomly divided into three groups. The groups include: control group (CC), nicotine group 1 (NC), in which their mothers received nicotine from gestational day 3 (GD3) to GD18, and nicotine group 2 (CN), in which young adult offspring rats received nicotine from postnatal day 42 (PD42) to PD56. Morris water maze (MWM) test was performed and then field excitatory postsynaptic potentials elicited by the stimulation of perforant pathway were recorded in the hippocampal dentate gyrus region. The results of the MWM test showed that learning and memory were impaired by either prenatal or postnatal nicotine exposure. In addition, it was found that there was no statistical difference of the MWM data between both nicotine treatments. In the electrophysiological test, LTP and STP were significantly inhibited in both NC and CN groups in comparison with the CC group. Notably, STP in CN group was also lower than that in the NC group. These findings suggested that both prenatal and postnatal exposure to nicotine induced learning and memory deficits, while the potential mechanism might be different from each other due to their dissimilar impairments of synaptic plasticity.
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Affiliation(s)
- G Han
- College of Life Science, Nankai University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - L An
- College of Life Science, Nankai University, Tianjin, China
| | - B Yang
- College of Life Science, Nankai University, Tianjin, China
| | - L Si
- College of Life Science, Nankai University, Tianjin, China
| | - T Zhang
- College of Life Science, Nankai University, Tianjin, China
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187
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Smith MA, Zhang Y, Polli JR, Wu H, Zhang B, Xiao P, Farwell MA, Pan X. Impacts of chronic low-level nicotine exposure on Caenorhabditis elegans reproduction: identification of novel gene targets. Reprod Toxicol 2013; 40:69-75. [PMID: 23735997 DOI: 10.1016/j.reprotox.2013.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/25/2013] [Accepted: 05/24/2013] [Indexed: 12/17/2022]
Abstract
Effects and mechanisms of chronic exposure to low levels of nicotine is an area fundamentally important however less investigated. We employed the model organism Caenorhabditis elegans to investigate potential impacts of chronic (24h) and low nicotine exposure (6.17-194.5 μM) on stimulus-response, reproduction, and gene expressions. Nicotine significantly affects the organism's response to touch stimulus (p=0.031), which follows a dose-dependent pattern. Chronic nicotine exposure promotes early egg-laying events and slightly increased egg productions during the first 72 h of adulthood. The expressions of 10 (egl-10, egl-44, hlh-14, ric-3, unc-103, unc-50, unc-68, sod-1, oxi-1, and old-1) out of 18 selected genes were affected significantly. Other tested genes were cat-4, egl-19, egl-47, egl-5, lin-39, unc-43, pink-1, and age-1. Changes in gene expression were more evident at low dosages than at relatively high levels. Genes implicated in reproduction, cholinergic signaling, and stress response were regulated by nicotine, suggesting widespread physiological impacts of nicotine.
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Affiliation(s)
- Michael A Smith
- Department of Biology, East Carolina University, Greenville, NC 27858, USA
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188
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Eicher JD, Powers NR, Cho K, Miller LL, Mueller KL, Ring SM, Tomblin JB, Gruen JR. Associations of prenatal nicotine exposure and the dopamine related genes ANKK1 and DRD2 to verbal language. PLoS One 2013; 8:e63762. [PMID: 23691092 PMCID: PMC3655151 DOI: 10.1371/journal.pone.0063762] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 04/05/2013] [Indexed: 01/09/2023] Open
Abstract
Language impairment (LI) and reading disability (RD) are common pediatric neurobehavioral disorders that frequently co-occur, suggesting they share etiological determinants. Recently, our group identified prenatal nicotine exposure as a factor for RD and poor reading performance. Using smoking questionnaire and language data from the Avon Longitudinal Study of Parents and Children, we first determined if this risk could be expanded to other communication disorders by evaluating whether prenatal nicotine exposure increases risk for LI and poor performance on language tasks. Prenatal nicotine exposure increased LI risk (OR = 1.60; p = 0.0305) in a dose-response fashion with low (OR = 1.25; p = 0.1202) and high (OR = 3.84; p = 0.0002) exposures. Next, hypothesizing that the effects of prenatal nicotine may also implicate genes that function in nicotine related pathways, we determined whether known nicotine dependence (ND) genes associate with performance on language tasks. We assessed the association of 33 variants previously implicated in ND with LI and language abilities, finding association between ANKK1/DRD2 and performance on language tasks (p≤0.0003). The associations of markers within ANKK1 were replicated in a separate LI case-control cohort (p<0.05). Our results show that smoking during pregnancy increases the risk for LI and poor performance on language tasks and that ANKK1/DRD2 contributes to language performance. More precisely, these findings suggest that prenatal environmental factors influence in utero development of neural circuits vital to language. Our association of ANKK1/DRD2 further implicates the role of nicotine-related pathways and dopamine signaling in language processing, particularly in comprehension and phonological memory.
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Affiliation(s)
- John D. Eicher
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Natalie R. Powers
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Kelly Cho
- Departments of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts Veterans Epidemiology Research and Information Center, Boston, Massachusetts, United States of America
| | - Laura L. Miller
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Kathryn L. Mueller
- Departments of Speech, Pathology, and Audiology, University of Iowa, Iowa City, Iowa, United States of America
| | - Susan M. Ring
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - J. Bruce Tomblin
- Departments of Speech, Pathology, and Audiology, University of Iowa, Iowa City, Iowa, United States of America
| | - Jeffrey R. Gruen
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Departments of Pediatrics and Investigative Medicine, Yale Child Health Research Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
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189
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Cho K, Frijters JC, Zhang H, Miller LL, Gruen JR. Prenatal exposure to nicotine and impaired reading performance. J Pediatr 2013; 162:713-718.e2. [PMID: 23122624 PMCID: PMC3577994 DOI: 10.1016/j.jpeds.2012.09.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 08/22/2012] [Accepted: 09/19/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate whether prenatal exposure to nicotine has an impact on several reading skill outcomes in school age children. STUDY DESIGN Using a longitudinal sample of 5119 school age children in the Avon Longitudinal Study of Parents and Children, this study investigated specific reading skill outcomes in the area of speed, fluency, accuracy, spelling, and comprehension in relation to prenatal nicotine exposure, after adjusting for potential mediators and confounders. Prenatal nicotine exposure was divided into 3 categories: high (>17 mg per day), low (≤17 mg per day), and no exposure. RESULTS We found that prenatal nicotine exposure was associated with increased risk of underperformance in specific reading skill outcomes after adjusting for potential mediators and confounders (P = .006). The effect of poor performance in decoding single words was most pronounced among children with prenatal exposure to high levels of nicotine in conjunction with a phonological deficit. Overall, the results showed that maternal smoking has moderate to large associations with delayed or decreased reading skills of children in the Longitudinal Study of Parents and Children. CONCLUSIONS High prenatal nicotine exposure has a negative association with reading performance in school age children. In addition, modeling showed that environmental factors significantly moderated the interaction between prenatal nicotine exposure and reading skill outcomes.
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Affiliation(s)
- Kelly Cho
- Department of Epidemiology and Public Health, Yale University School of Medicine New Haven, CT 06520, U.S.A
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, U.S.A
- Massachusetts Veterans Epidemiology Research and Information Center, Veterans Administration Boston Healthcare System, Boston, MA 02130, U.S.A
- Departments of Pediatrics, Genetics and Investigative Medicine, Yale Child Health Research Center, Yale University School of Medicine, New Haven, CT 06520, U.S.A
| | - Jan C. Frijters
- Departments of Child and Youth Studies and Psychology, Brock University, Ontario, Canada
| | - Heping Zhang
- Department of Epidemiology and Public Health, Yale University School of Medicine New Haven, CT 06520, U.S.A
| | - Laura L. Miller
- School of Social and Community Medicine, University of Bristol, Bristol, U.K
| | - Jeffrey R. Gruen
- Departments of Pediatrics, Genetics and Investigative Medicine, Yale Child Health Research Center, Yale University School of Medicine, New Haven, CT 06520, U.S.A
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190
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Narkowicz S, Płotka J, Polkowska Ż, Biziuk M, Namieśnik J. Prenatal exposure to substance of abuse: a worldwide problem. ENVIRONMENT INTERNATIONAL 2013; 54:141-163. [PMID: 23454110 DOI: 10.1016/j.envint.2013.01.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 01/15/2013] [Accepted: 01/20/2013] [Indexed: 06/01/2023]
Abstract
Substance abuse during pregnancy is an important public health issue affecting the mother and the growing infant. Preterm labor, miscarriage, abruption and postpartum hemorrhage are obstetric complications which have been associated with women who are dependent on abused substances. Moreover, women are also at an increased risk of medical problems such as poor nutrition, anemia, urinary tract infections as well as sexually transmitted infections, hepatitis, HIV and problems related to infection. Intrauterine growth restriction, prematurity, stillbirth, neonatal abstinence syndrome, and Sudden Infant Death Syndrome represent only some of fetal effects. Later on, during childhood, it has been shown that in utero exposure to substances of abuse is associated with increased rates of respiratory infections, asthma, ear and sinus infections. Moreover, these children are more irritable, have difficulty focusing their attention, and have more behavioral problems. Therefore, the assessment of in utero exposure to abused substance is extremely necessary and is relevant for the care of the mother and the offspring. In this sense, several approaches are possible; however, recently the evaluation of in utero exposure to abused drugs has been achieved by testing biological specimens coming from fetus or newborn, pregnant or nursing mother, or from both the fetus and the mother. Maternal and neonatal biological materials reflect exposure in a specific time period and each of them has different advantages and disadvantages in terms of accuracy, time window of exposure and cost/benefit ratio. The methodology for identification and determination of abused substances in biological materials are of great importance. Consequently, sensitive and specific bioanalytical methods are necessary to accurately measure biomarkers. Different immunoassays methods are used as screening methods for drug testing in the above reported specimens, however, the results from immunoassays should be carefully interpreted and confirmed by a more specific and sensitive chromatographic methods such as GC-MS or LC-MS. The interest in the development and optimization of analytical techniques to detect abused substances in different specimens is explained by the several possibilities and information that they can provide.
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Affiliation(s)
- Sylwia Narkowicz
- Department of Analytical Chemistry, Chemical Faculty, Gdansk University of Technology (GUT) 11/12 Narutowicza Street, 80-233 Gdańsk, Poland.
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191
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Hughes JR. An updated algorithm for choosing among smoking cessation treatments. J Subst Abuse Treat 2013; 45:215-21. [PMID: 23518288 DOI: 10.1016/j.jsat.2013.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 01/03/2013] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
Abstract
Although meta-analyses have documented the efficacy of treatments for smoking cessation, and guidelines have outlined treatment elements, few algorithms for choosing among treatments have been described. The current algorithm updates the author's prior algorithm. The major decisions in the algorithm are (a) use a motivational treatment if the smoker is not currently interested in quitting, (b) assess factors that influence choice of treatment, (c) consider both gradual and abrupt cessation, (d) use combined patch+gum/inhaler/lozenge or varenicline as first line medications, (e) use individual, group, Internet, and phone counseling as first line psychosocial treatments, and (f) continue treatment after a lapse or relapse. Further research is needed to determine whether algorithms improve treatment outcomes.
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Affiliation(s)
- John R Hughes
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
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192
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De Long N, Hyslop JR, Nicholson CJ, Morrison KM, Gerstein HC, Holloway AC. Postnatal metabolic and reproductive consequences of fetal and neonatal exposure to the smoking cessation drug bupropion. Reprod Sci 2013; 20:1156-61. [PMID: 23439618 DOI: 10.1177/1933719113477493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In all, 10% to 20% of all pregnant women smoke despite intentions to quit. Smoking cessation drugs such as nicotine replacement therapy (NRT) and bupropion are recommended for pregnant women. Our observation that developmental exposure to nicotine adversely affects metabolic and reproductive outcomes in rats has raised concerns about NRT's safety during pregnancy. Conversely, the effect of bupropion has not been reported. OBJECTIVE The goal of this study was to examine the effect of fetal and neonatal exposure to bupropion on postnatal metabolic and reproductive outcomes. METHODS Dams (N = 5/group) were exposed to saline or bupropion (5 or 10 mg/kg per d) for 2 weeks prior to mating until weaning. We assessed weight, adiposity, and glucose homeostasis in all offspring until 26 weeks of age. Onset of puberty, fertility, and pregnancy outcomes in the female offspring were also assessed. RESULTS Fetal and neonatal exposure to bupropion did not cause metabolic derangement in the offspring despite a significant decrease in birth weight in the offspring of dams treated with 10/mg/kg per d bupropion (5.9 ± 0.2 g vs control 6.7 ± 0.2 g; P = .02). Moreover, with the exception of accelerated pubertal onset in F1 and F2 offspring, bupropion administration to pregnant dams had no impact on fertility or pregnancy outcomes for either the dam or the female offspring. CONCLUSION Fetal and neonatal exposure to the smoking cessation drug bupropion, unlike NRT, does not appear to adversely affect metabolic outcomes or the fertility of the female offspring. However, bupropion does appear to alter pubertal onset through an as yet unknown mechanism.
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Affiliation(s)
- Nicole De Long
- 1Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Brajenović N, Karačonji IB, Mikolić A, Stasenko S, Piasek M. Tobacco smoke and pregnancy: segmental analysis of nicotine in maternal hair. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2013; 68:117-122. [PMID: 23428062 DOI: 10.1080/19338244.2012.658121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The investigation assessed nicotine metabolism prior to and during pregnancy in relation to different maternal smoking habits. It included segmental hair analysis in 3 groups of postpartum women: 32 active smokers, 35 passive smokers, and 19 unexposed nonsmokers. Maternal hair at least 12 cm long was collected after delivery and was divided into four 3-cm-long segments representing each trimester of pregnancy and the 3 months prior to pregnancy. Hair nicotine concentration was determined by gas chromatography-mass spectrometry. Nicotine levels were the highest in the 3-month period before pregnancy and it gradually decreased with advancing gestation in all study groups. These results suggest that when assessing tobacco exposure as measured by nicotine in hair, metabolic changes of nicotine during pregnancy should be taken into consideration.
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Affiliation(s)
- Nataša Brajenović
- Institute for Medical Research and Occupational Health, HR-10001 Zagreb, Croatia.
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194
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Effects of tobacco smoking in pregnancy on offspring intelligence at the age of 5. J Pregnancy 2012; 2012:945196. [PMID: 23316364 PMCID: PMC3539404 DOI: 10.1155/2012/945196] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 11/22/2012] [Indexed: 12/02/2022] Open
Abstract
The aim of the study was to examine the effects of tobacco smoking in pregnancy on children's IQ at the age of 5. A prospective follow-up study was conducted on 1,782 women, and their offspring were sampled from the Danish National Birth Cohort. At 5 years of age, the children were tested with the Wechsler Preschool and Primary Scale of Intelligence-Revised. Parental education, maternal IQ, maternal alcohol consumption in pregnancy, the sex and age of the child, and tester were considered core confounders, but the full model also controlled for prenatal paternal smoking, maternal age and Bodymass Mass Index, parity, family/home environment, postnatal parental smoking, breast feeding, the child's health status, and indicators for hearing and vision impairments.
Unadjusted analyses showed a statistically significant decrement of 4 points on full-scale IQ (FSIQ) associated with smoking 10+ cigarettes per day compared to nonsmoking. After adjustment for potential confounders, no significant effects of prenatal exposure to tobacco smoking were found. Considering the indisputable teratogenic effects of tobacco smoking, these findings should be interpreted with caution. Still, the results may indicate that previous studies that failed to control for important confounders, particularly maternal intelligence, may be subject to substantial residual confounding.
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195
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Phillips DH, Venitt S. DNA and protein adducts in human tissues resulting from exposure to tobacco smoke. Int J Cancer 2012; 131:2733-53. [PMID: 22961407 DOI: 10.1002/ijc.27827] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/03/2012] [Indexed: 12/15/2022]
Abstract
Tobacco smoke contains a variety of genotoxic carcinogens that form adducts with DNA and protein in the tissues of smokers. Not only are these biochemical events relevant to the carcinogenic process, but the detection of adducts provides a means of monitoring exposure to tobacco smoke. Characterization of smoking-related adducts has shed light on the mechanisms of smoking-related diseases and many different types of smoking-derived DNA and protein adducts have been identified. Such approaches also reveal the potential harm of environmental tobacco smoke (ETS) to nonsmokers, infants and children. Because the majority of tobacco-smoke carcinogens are not exclusive to this source of exposure, studies comparing smokers and nonsmokers may be confounded by other environmental sources. Nevertheless, certain DNA and protein adducts have been validated as biomarkers of exposure to tobacco smoke, with continuing applications in the study of ETS exposures, cancer prevention and tobacco product legislation. Our article is a review of the literature on smoking-related adducts in human tissues published since 2002.
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Affiliation(s)
- David H Phillips
- Analytical and Environmental Sciences Division, MRC-HPA Centre for Environment and Health, King's College London, London, United Kingdom.
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196
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Makinen S, Soderstrom-Anttila V, Vainio J, Suikkari AM, Tuuri T. Does long in vitro culture promote large for gestational age babies? Hum Reprod 2012; 28:828-34. [DOI: 10.1093/humrep/des410] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Abstract
A large number of people are using smokeless tobacco and areca nut worldwide. Sufficient data on tobacco smoking have harmful effect on human health and reproduction is available. However, data on the smokeless tobacco and areca nut use on human reproduction is scanty. This overview is an attempt to compose on the consumption of smokeless tobacco and areca nut on human reproduction and some relevant experimental data were also included. The existing studies suggest that tobacco and areca nut chewing alone, together or with other ingredients had reproductive toxic potential. Pregnant women using smokeless tobacco during pregnancy also had adverse effect on pregnancy and its outcome. Thus pregnant women must avoid consumption of any mixture containing areca nut and tobacco in order to protect the pregnancy and outcome. The data suggest that smokeless tobacco use is also harmful as smoking for reproduction and use of areca nut might have further compounded the problem.
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Affiliation(s)
- Sunil Kumar
- Division of Reproductive and Cyto-toxicology, National Institute of Occupational Health, (ICMR), Ahmedabad 380016, India.
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198
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Suter MA, Anders AM, Aagaard KM. Maternal smoking as a model for environmental epigenetic changes affecting birthweight and fetal programming. Mol Hum Reprod 2012; 19:1-6. [PMID: 23139402 DOI: 10.1093/molehr/gas050] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Although the association between maternal smoking and low birthweight infants has been well established, the mechanisms behind reduced fetal growth are still being elucidated. While many infants are exposed to tobacco smoke in utero, not all are born growth restricted or small for gestational age. Many hypotheses have emerged to explain the differential response to in utero maternal tobacco smoke exposure (MTSE). Studies have shown that both maternal and fetal genotypes may contribute to the discrepant outcomes. However, the contribution of epigenetic changes cannot be ignored. In this review we address two important questions regarding the effect of MTSE on the fetal epigenome. First, does exposure to maternal tobacco smoke in utero alter the fetal epigenome? Secondly, could these alterations be associated with the reduced fetal growth observed with MTSE?
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Affiliation(s)
- Melissa A Suter
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, 1 Baylor Plaza, Jones 314, Houston, TX 77030, USA
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Kyriakopoulos P, Oskoui M, Dagenais L, Shevell MI. Does antenatal tobacco or alcohol exposure influence a child's cerebral palsy? A population-based study. Pediatr Neurol 2012; 47:349-54. [PMID: 23044017 DOI: 10.1016/j.pediatrneurol.2012.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/01/2012] [Indexed: 12/18/2022]
Abstract
Antenatal tobacco and alcohol exposure are established risk factors for premature birth and an independent risk factor for cerebral palsy. Both exert adverse effects on fetal development. In children with cerebral palsy, whether antenatal exposure to tobacco or alcohol is associated with a difference in clinical profile remains unknown. The Quebec Cerebral Palsy Registry was used to compare neurologic subtypes, gross motor functional impairment, and comorbidities in children with cerebral palsy who were or were not prenatally exposed to alcohol or tobacco. Information on in utero exposure was available in 249 children with cerebral palsy born from 1999-2002, of whom 77 were exposed to alcohol and 62 to tobacco in utero. No association was evident between exposure to tobacco or alcohol during pregnancy and neurologic subtype, Gross Motor Function Classification System score, mean number of comorbidities experienced, or each of eight comorbidities explored. Adjusting for prematurity or low birth weight exerted no effect on these results. In utero exposure to tobacco or alcohol does not assist in predicting clinical profiles of cerebral palsy.
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Affiliation(s)
- Paulina Kyriakopoulos
- Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Center, Montreal, Quebec, Canada
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200
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Financial incentives for smoking cessation among pregnant and newly postpartum women. Prev Med 2012; 55 Suppl:S33-40. [PMID: 22227223 PMCID: PMC3399924 DOI: 10.1016/j.ypmed.2011.12.016] [Citation(s) in RCA: 175] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 12/16/2011] [Accepted: 12/17/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Smoking during pregnancy is the leading preventable cause of poor pregnancy outcomes in the U.S., causing serious immediate and longer-term adverse effects for mothers and offspring. In this report we provide a narrative review of research on the use of financial incentives to promote abstinence from cigarette smoking during pregnancy, an intervention wherein women earn vouchers exchangeable for retail items contingent on biochemically-verified abstinence from recent smoking. METHODS Published reports based on controlled trials are reviewed. All of the reviewed research was conducted by one of two research groups who have investigated this treatment approach. RESULTS Results from six controlled trials with economically disadvantaged pregnant smokers support the efficacy of financial incentives for increasing smoking abstinence rates antepartum and early postpartum. Results from three trials provide evidence that the intervention improves sonographically estimated fetal growth, mean birth weight, percent of low-birth-weight deliveries, and breastfeeding duration. CONCLUSIONS The systematic use of financial incentives has promise as an efficacious intervention for promoting smoking cessation among economically disadvantaged pregnant and recently postpartum women and improving birth outcomes. Additional trials in larger and more diverse samples are warranted to further evaluate the merits of this treatment approach.
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