Bergsjø Per, Bakketeig Leiv S, Lindmark Gunilla
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
Acta Obstet Gynecol Scand. 2007;86(2):156-60. doi: 10.1080/00016340600984696.
Cigarette smoking during pregnancy is causally related to birthweight, but we do not know whether fetal growth restriction is a continuous process or, if not, at what stage of pregnancy it affects weight gain.
A random sample of para 1 and 2 mothers, drawn from the population of pregnant women in Bergen and Trondheim, Norway, and Uppsala, Sweden, were examined by a detailed questionnaire concerning smoking habits, menstrual history and pregnancy dating, and subjected to morphometric sonography of their fetuses in or around week 17. Of the 547 study participants, 31.9% were smokers. Gestational age was primarily determined by the last menstrual period [LMP], except in those with irregular cycles, and in 30 cases (6.6% of those with regular cycles) in whom the biparietal diameter [BPD]-determined age deviated >14 days from the LMP-based date.
The analysis did not reveal any statistically significant differences between the fetuses of non-smokers, light smokers (0-9 cigarettes per day) and heavy (10+ cigarettes per day) smokers, regarding BPD, mean abdominal diameter [MAD] femur length [FL], and a 'body contour index': [BPD+FL]/MAD.
Tobacco-induced fetal growth restriction probably begins after gestational week 17.
孕期吸烟与出生体重存在因果关系,但我们尚不清楚胎儿生长受限是一个持续的过程,若不是,它在孕期的哪个阶段会影响体重增加。
从挪威卑尔根和特隆赫姆以及瑞典乌普萨拉的孕妇群体中随机抽取经产妇(初产妇和经产妇)作为样本,通过一份关于吸烟习惯、月经史和孕周确定的详细问卷进行调查,并在妊娠第17周左右对其胎儿进行形态学超声检查。在547名研究参与者中,31.9%为吸烟者。孕周主要根据末次月经日期(LMP)确定,月经周期不规律者除外,在30例(月经周期规律者的6.6%)中,双顶径(BPD)确定的孕周与基于LMP的日期相差超过14天。
分析未发现非吸烟者、轻度吸烟者(每天0 - 9支香烟)和重度吸烟者(每天10支及以上香烟)的胎儿在BPD、平均腹径(MAD)、股骨长度(FL)以及“身体轮廓指数”[BPD + FL]/MAD方面存在任何统计学上的显著差异。
烟草导致的胎儿生长受限可能在妊娠第17周后开始。