Baki Yıldırım Sema, Ayaydın Yılmaz Kıymet İclal, Gulerman Cavidan
Gynecology and Obstetrics, Giresun University Faculty of Medicine, Gynecology and Pediatrics Training and Research Hospital, Giresun, TUR.
Department of Obstetrics and Gynecology, Zekai Tahir Burak Women Health Care Education and Research Hospital, Ankara, TUR.
Cureus. 2023 Feb 21;15(2):e35270. doi: 10.7759/cureus.35270. eCollection 2023 Feb.
Maternal smoking is associated with an increased risk of obstetric and neonatal complications during pregnancy. We aimed to investigate the effects of active and passive smoking on fetal-maternal blood flow and fetal complications in mid-trimester pregnant women.
This prospective study was conducted at Zekai Tahir Burak Women's Research and Training Hospital and included women who were 20 to 22 weeks old, with no fetal anomalies, and with a singleton pregnancy. The data used in the analysis were obtained from a total of 168 pregnant women (50 smokers, 50 passive smokers, and 68 non-smokers). Starting from their 20 week of pregnancy, the women were examined at least once in each trimester. Fetal and maternal pregnancy results were evaluated. Fetal biometry, umbilical, and uterine artery Doppler ultrasonography were performed. To evaluate the flow in these veins, the pulsatility index, resistance index, and systole/diastole (S/D) ratio were performed.
The mean age of study patients was 25.06 ± 4.36 years and the mean gestational week was 20.03 ± 0.6 weeks. In terms of the umbilical artery pulsatility index (UMBAPI), umbilical artery systolic/diastolic ratio (UMBAS/D),uterine artery resistance index (UARI), uterine artery pulsatility index (UAPI), and uterine artery systolic/diastolic ratio (UAS/D) levels, the mean value of the smoker group was significantly higher compared to the non-smoker group (p<0.001, p=0.043, p=0.021, p=0.020, and p=0.037, respectively). The birth weight of the fetus was significantly lower in the active and passive smoker groups than in the non-smoker group (p=0.009 and p=0.006, respectively). The number of patients diagnosed with intrauterine growth restriction (IUGR) and oligohydramnios were significantly higher in the smoker group than in the passive smoker and non-smoker groups (p=0.003 and p<0.001, respectively). The risk of low birth weight (OR, (95% CI): 3.38 (2.05 - 5.57); p=0.024), oligohydramnios (OR (95% CI): 13.44 (5.22 - 34.57); p=0.001), IUGR (OR (95% CI): 9.33 (4.50 - 19.33); p=0.001), and preterm birth (OR (95% CI): 4.56 (1.25 - 17.32); p=0.001) increased significantly in the active and passive cigarette exposure groups, compared to the non-smokers.
During pregnancy, both smoking and passive exposure to cigarette smoke adversely affect the fetus and the newborn. Uterine and umbilical artery Doppler measurements in pregnant women who smoke are significantly higher than the pregnant women who do not smoke.
孕期母亲吸烟会增加产科和新生儿并发症的风险。我们旨在研究主动吸烟和被动吸烟对孕中期孕妇胎儿-母体血流及胎儿并发症的影响。
这项前瞻性研究在泽凯·塔希尔·布拉克妇女研究与培训医院进行，纳入了年龄在20至22周、无胎儿异常且为单胎妊娠的妇女。分析中使用的数据来自总共168名孕妇（50名吸烟者、50名被动吸烟者和68名非吸烟者）。从怀孕20周开始，这些妇女在每个孕期至少接受一次检查。评估胎儿和母亲的妊娠结局。进行胎儿生物测量、脐动脉和子宫动脉多普勒超声检查。为评估这些血管中的血流，测量搏动指数、阻力指数和收缩期/舒张期（S/D）比值。
研究患者的平均年龄为25.06±4.36岁，平均孕周为20.03±0.6周。在脐动脉搏动指数（UMBAPI）、脐动脉收缩期/舒张期比值（UMBAS/D）、子宫动脉阻力指数（UARI）、子宫动脉搏动指数（UAPI）和子宫动脉收缩期/舒张期比值（UAS/D）水平方面，吸烟者组的平均值显著高于非吸烟者组（分别为p<0.001、p=0.043、p=0.021、p=0.020和p=0.037）。主动吸烟和被动吸烟组胎儿的出生体重显著低于非吸烟者组（分别为p=0.009和p=0.006）。吸烟者组中诊断为宫内生长受限（IUGR）和羊水过少的患者数量显著高于被动吸烟者和非吸烟者组（分别为p=0.003和p<0.001）。与非吸烟者相比，主动吸烟和被动吸烟暴露组低出生体重（OR，（95%CI）：3.38（2.05 - 5.57）；p=0.024）、羊水过少（OR（95%CI）：13.44（5.22 - 34.57）；p=0.001）、IUGR（OR（95%CI）：9.33（4.50 - 19.33）；p=0.001）和早产（OR（95%CI）：4.56（1.25 - 17.32）；p=0.001）的风险显著增加。
孕期吸烟和被动接触香烟烟雾均会对胎儿和新生儿产生不利影响。吸烟孕妇的子宫和脐动脉多普勒测量值显著高于不吸烟孕妇。
