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.
Highlights
Smoking is the leading cause of preventable deaths in the world [1, 2, 3], causing the deaths of approximately 6 million people per year [4, 5]
There were no significant differences in age or obstetric aspects between the groups (Table 1)
There were no significant differences between controls and passive smokers, represented by letter a in Table 2: urinary cotinine P50.57, amniotic fluid cotinine P50.92, umbilical cord cotinine P50.99, 1-hydroxypyrene in maternal urine P50.39, 1-hydroxypyrene in amniotic fluid P50.86 and benzopyrene in umbilical cord P50.47
Summary
Smoking is the leading cause of preventable deaths in the world [1, 2, 3], causing the deaths of approximately 6 million people per year [4, 5]. Cigarette smoking before and during pregnancy is an important cause of preventable illness and death among mothers and their children and impacts on pregnancies in younger women with lower educational level [6]. Placental abruption, which occurs in approximately 1% of pregnancies, is 20 to 30 times more frequent in pregnant smokers [16]. Cigarette smoke contains numerous carcinogens that cross the placenta [17], increasing the risk of childhood cancer, such as brain tumors, leukemia and lymphoma [18]
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