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Effects of Smoking in Pregnancy!
Around 30 per cent of women who smoke in the UK continue to smoke during pregnancy. Cigarettes affect the mother’s circulation, which in turn will affect the baby. The baby in the womb is completely dependent on mother to provide oxygen, nourish and filter out any dangerous chemicals.
o “The placenta (afterbirth) is the lifeline between mother and baby. When a pregnant woman smokes, oxygen in her blood is replaced by carbon monoxide. Carbon monoxide is a poisonous gas that robs muscles, brain and body tissues of oxygen making the baby’s heart works harder. If the baby is deprived of oxygen, it will suffer from its effects, which is known as hypoxia. The effect of hypoxia occurs over a long period of time. The most immediate effect for the baby is his/her movements inside. the uterus slows down and the heart rate increases as the baby tries to get more oxygen. There is a reduction in the baby’s movements up to thirty minutes after the mother has smoked one cigarette.
o “The placenta provides the baby with nutrients; smoking increases the chance that the baby will be born smaller than expected. (Low Weight Baby). Research suggests that some women see a baby with a low weight as an advantage, however there is so much evidence to the contrary. If the baby is smaller at birth, it will continue to be smaller during its subsequent development. Low birth weight babies are more likely to need intensive care.
o ” The placenta acts as a barrier/filter for certain substances. Unfortunately it cannot keep them all out and many pass through. Nicotine, carbon monoxide, and other chemicals in tobacco smoke are passed on to the baby. There are 4000 chemicals in cigarettes of which there are more than 30 known carcinogens. A German study showed traces of NNK, (nicotine-derived nitrosamine ketone) which is one of the strongest cancer agents found in tobacco products. It was detected in 22 out of 31 newborns of mothers who smoked during pregnancy.
Effects of Nicotine
Nicotine travels through the bloodstream to the brain, and is then delivered to the rest of the body.
80% of nicotine is broken down to cotinine by enzymes in the liver. Accumulation of cotinine can act on the uterus causing it to contract or give birth. Many chemicals, including nicotine, can easily move from the mother’s bloodstream into the fetal blood supply. (This is why doctors are so careful about what over-the-counter or prescription drugs women take during pregnancy.) If you smoke while pregnant, your child will be exposed to almost the same level of nicotine as you. This means that after he or she is born and no longer receives nicotine intravenously, the symptoms of nicotine withdrawal are likely to appear.
Clinical studies reported that nicotine concentrations in the placenta, amniotic fluid and fetal serum were consistently higher than maternal serum values when measured at various stages during pregnancy.
Nicotine changes a smoker’s blood pressure, heart rate and even their metabolism. Nicotine moves directly into the lining of small blood vessels causing them to narrow thus reducing blood flow to the uterus and then to the baby. Nicotine can inhibit the production of prostacyclin, a powerful vasodilator and inhibitor of platelet aggregation, in arteries. Studies have shown that nicotine increases uterine vascular resistance and reduces uterine blood flow, possibly by acting on catecholamine release. Smoking acutely and chronically reduces placental blood flow, presumably through an effect of nicotine.
There is evidence that nicotine impairs fetal growth and can lead to an increased risk of spontaneous abortion and premature birth. A probable cause of fetal growth retardation is the induction of fetal ischemia (reduced blood supply) and hypoxia (lack of oxygen) as a result of the effect of nicotine on the placental circulation.
Nicotine from cigarettes or replacement therapy has potential adverse effects on human health.
More than 8 million women smoke in the UK. Research among female smokers shows that 74% would like to quit smoking but despite these attempts most women continue to depend on nicotine and experience difficulty overcoming their addiction to the drug.
Pregnant women who smoke are often strongly encouraged to quit, especially during early pregnancy, but many continue to smoke. Smoking among expectant mothers in the UK is surprisingly high at 23% and only 3% of people quit smoking successfully when relying on willpower alone.
There are increased risks in pregnancy when the mother smokes. The risk of miscarriage is 27% higher in smokers. Perinatal mortality (defined as stillbirth or death of a baby within the first week of life) is increased by about one-third in babies of smokers. The risk of a low birth weight baby (200 grams 7 oz) is three times higher. In addition, the more cigarettes a woman smokes during pregnancy, the greater is the likely reduction in birth weight.
Recent research suggests that cigarettes can reduce blood flow in the placenta, which limits the amount of nutrients that reach the fetus. There is a 35% increase in cot deaths associated with smoking during pregnancy. Maternal smoking is associated with a higher risk of childhood cancers. Children of parents who smoke are twice as likely to suffer from a serious respiratory infection than the children of non-smokers. Smoking during pregnancy can also increase the risk of asthma in young children.
Maternal smoking in pregnancy has been associated with conduct and attention deficit disorders. Mothers who smoked more than ½ pack of cigarettes were significantly more likely to have offspring with conduct disorder. Substance abuse is higher among children of mothers who smoked during pregnancy and also impaired child rearing. Smoking in pregnancy can also have implications for the child’s long-term physical growth and intellectual development. It was associated with reduced height in children of smoking mothers compared to non-smoking mothers, with lower achievements in reading and mathematics up to age 16 and even with the highest fitness achieved before age 23.
On average, smokers have more pregnancy and delivery complications, which can include bleeding during pregnancy, premature removal of the placenta and premature rupture of the membranes. Some studies have also revealed a link between smoking and ectopic pregnancy and birth defects in the offspring of smokers. Women are more likely to experience vomiting, urinary tract infections, thrush, feel unwell and have more hospital admissions. There is also evidence that smoking disrupts a woman’s hormonal balance during pregnancy and that this can have long-term consequences on the reproductive organs of her children.
In December 1998, the UK government set a target to reduce the percentage of women who smoke during pregnancy from 23% to 15% by the year 2010; with a fall of up to 18% by the year 2005. This will mean approximately 55,000 fewer women in England who smoke during pregnancy. This goal has not yet been achieved.
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4-(methylnitrosoamino)-1-(3-pyridyl)-1-butanone (nnk) in the urine of newborn infants. Abstract Papers Am Chem. Soc 1998
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16 Landgren et al. (1998)
7 Wakschlag et al. (1997)
18 Ferguson et al. (1998)
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23 Golding, J. HEA Conference on smoking and pregnancy 
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