Chełchowska Magdalena, Gajewska Joanna, Ambroszkiewicz Jadwiga, Lewandowski Leszek, Maciejewski Tomasz M, Ołtarzewski Mariusz, Laskowska-Klita Teresa
Zaklad Badarń Przesiewowych, Instytut Matki i Dziecka w Warszawie.
Klinika Poloznictwa i Ginekologii, Instytut Matki i Dziecka w Warszawie.
Przegl Lek. 2013;70(10):800-4.
The objective of this study was to evaluate the effect of cigarette smoking on concentration of selected angiogenic factors (vascular endothelial growth factor VEGF, placenta growth factor PIGF) and somatomedin C (insulin-like growth factor-I) in blood of mothers and umbilical cord blood. The correlations between studied biochemical parameters and markers of estimated intensity of cigarette smoking as well as birth weight were also determined. Fifty healthy pregnant women were divided into two groups: smoking and tobacco abstinent group according to serum cotinine concentration. The current smokers were defined as those who had smoked 5 cigarettes per day for 2 years before conception and continued smoking during pregnancy. In the group of smoking mothers the mean serum concentration of cotinine was 91.6 microg/L and correlated positively with number of cigarettes daily consumed (r = 0.58, p < 0.01) as well as with time of smoking before conception (r = 0.40, p < 0.05). The mean serum concentration of PIGF in III trimester of pregnancy was significantly higher in the group of smokers than in non-smoking ones (p < 0.0001) and correlated with serum cotinine concentration (r = 0.41, p < 0.05) and number of cigarettes daily consumed (r = 0.58, p < 0.01). The concentration of serum VEGF was similar in both studied group. The mean serum level of IGF-I was significantly lower in group of smokers than in non-smokers in the I and III trimester of gestation (p < 0.01). Also in umbilical cord blood of smoking newborn the concentration of IGF-I was lower by 20% than in nonsmoking group (p < 0.05). We observed negative correlation between number of cigarettes daily consumed and serum level of IGF-I in blood of mothers as well as in blood of their children (I trimester: r = -0.43, p < 0.05; III trimester: r = -0.70, p < 0.001; umbilical cord blood: r = -0.45, p < 0.05). In both studied groups there were a positive correlation between birth weight and concentrations of IGF-I in blood of mothers and umbilical cord blood (group of smokers: mothers r = 0.43, p < 0.05, cord blood r = 0.50, p < 0.01; group of tobacco abstinent: mothers r = 0.51, p < 0.01, cord blood r = 0.41, p < 0.05). The birth weight of the smoking mothers' infants was lower by about 400 g (p < 0.01) and their birth body length by 1.5 cm (p < 0.05) and negatively correlated with number of cigarettes smoked per day (r = -0.55; p < 0.005). Our results indicate, that tobacco smoking during pregnancy increased serum PIGF levels in the final stages of gestation and has no effect on the concentration of VEGF, which may lead to an increase of trophoblast proliferation and uteroplacental dysfunction. Lower than in tobacco abstinent levels of IGF-I in serum of smoking mothers and in umbilical cord blood and their close relationship with birth weight, may suggests a direct effect of this factor on birth anthropometric parameters.
本研究的目的是评估吸烟对母亲血液和脐带血中所选血管生成因子(血管内皮生长因子VEGF、胎盘生长因子PIGF)以及生长调节素C(胰岛素样生长因子-I)浓度的影响。还确定了所研究的生化参数与估计吸烟强度标志物以及出生体重之间的相关性。根据血清可替宁浓度,将50名健康孕妇分为两组:吸烟组和戒烟组。当前吸烟者定义为在受孕前2年每天吸烟5支且在孕期持续吸烟的人。在吸烟母亲组中,可替宁的平均血清浓度为91.6μg/L,与每日吸烟量呈正相关(r = 0.58,p < 0.01),也与受孕前吸烟时间呈正相关(r = 0.40,p < 0.05)。孕期第三个月时,吸烟组中PIGF的平均血清浓度显著高于非吸烟组(p < 0.0001),且与血清可替宁浓度(r = 0.41,p < 0.05)和每日吸烟量(r = 0.58,p < 0.01)相关。两个研究组中血清VEGF的浓度相似。在妊娠第一和第三个月时,吸烟组中IGF-I的平均血清水平显著低于非吸烟组(p < 0.01)。在吸烟新生儿的脐带血中,IGF-I的浓度也比非吸烟组低20%(p < 0.05)。我们观察到母亲血液及其子女血液中每日吸烟量与IGF-I血清水平呈负相关(妊娠第一个月:r = -0.43,p < 0.05;第三个月:r = -0.70,p < 0.001;脐带血:r = -0.45,p < 0.05)。在两个研究组中,母亲血液和脐带血中出生体重与IGF-I浓度均呈正相关(吸烟组:母亲r = 0.43,p < 0.05,脐带血r = 0.50,p < 0.01;戒烟组:母亲r = 0.51,p < 0.01,脐带血r = 0.41,p < 0.05)。吸烟母亲所生婴儿的出生体重低约400g(p < 0.01),出生身长短1.5cm(p < 0.05),且与每日吸烟量呈负相关(r = -0.55;p < 0.005)。我们的结果表明,孕期吸烟会增加妊娠后期血清PIGF水平,对VEGF浓度无影响,这可能导致滋养层细胞增殖增加和子宫胎盘功能障碍。吸烟母亲血清和脐带血中IGF-I水平低于戒烟组,且与出生体重密切相关,这可能表明该因子对出生人体测量参数有直接影响。