Smoking Mothers Research Articles

RISK FACTORS - INFLUENCING THE HEALTH OF PRESCHOOL CHILDREN

Purpose: to study the risk factors of recurrent acute respiratory viral infection (ARVI) in preschool children living in ecologically different districts of Perm. Methods. Retrospectively 710 records of 5-6 year old children with recurrent diseases of ARVI living in Ordzhonikidze district (group 1, n = 350) and Industrial district (group 2, n = 360) were evaluated. The study assessed the socio-biological risk factors of recurrent SARS and developed a prognostic factor by the method of Wald. Results. In group 2 children in the first year of life were more likely to have anemia 39.0 (95 % CI: 167.6-112.4) %, rickets 55.6 (95 % CI: 234.9-165.1) %, atopic dermatitis 55.6 (95 % CI: 272.9-127.1) %. In group 1, these diseases were less common - anemia 28.6 (95 % CI: 117.3-82.7) %, rickets 43 (95 % CI: 167.3-132.7) %, atopic dermatitis 28.6 (95 % CI: 148.8-51.2) %. Biologically significant risk factors for the formation of recurrent ARVI are: Smoking of the mother, the incidence of ARVI in the 1st half of pregnancy, etc. Mother's Smoking was more common in group 2 - 30.6 (95 % CI: 174.1-45.9) % against 3.4 in group 1 (95 % CI: 16.4-7.6) %. In the group 2 pregnant women were frequently sick with colds in the 1st half of pregnancy was 50.0 (95 % CI: 228.9-131.1) % against 22.9 per cent (95 % CI: 122.5-37.5) % in the 1 group. A prognostic index was calculated for each factor. In terms of sum of prognostic index a forecast of frequent ARVI was determined in children up to 5 years. Conclusions. Biologically significant risk factors for frequent ARVI in children were identified in two Perm districts. The risk factors were: smoking of the mother, ARVI incidence in the 1st and 2nd half of pregnancy, anemia, medical abortions and the risk of termination of pregnancy. Depending on the size of Wald's prognostic index children get in to a favorable zone (from +0.87 to +3.11), an unfavorable zone (from -0.06 to -9.62) and a border zone (from -0.06 to +0.87).

Pregnancy Survey of Smoking and Alcohol Use in South Dakota American Indian and White Mothers

American Indian populations are believed to have relatively high tobacco use and alcohol consumption before and during pregnancy compared with other populations despite little evidence. Population-based survey distributed 2-6 months postpartum to 1,814 South Dakota mothers having a live birth in 2014. Prevalence of self-reported smoking and alcohol use before and during pregnancy were calculated for American Indian and white mothers and AORs were determined controlling for Hispanic status, marital status, age, education, and income. Analysis was completed in 2017-2018. Smoking among American Indian mothers was similar to white mothers before and during pregnancy (AOR=1.60, 95% CI=0.95, 2.67 and AOR=0.67, 95% CI=0.37, 1.21, respectively). Among smokers, a higher percentage of American Indian mothers smoked less than six cigarettes/day than white mothers (AOR=6.79, 95% CI=3.21, 14.35, before and AOR=4.85, 95% CI=1.08, 21.7, during pregnancy), and American Indian mothers had greater odds of quitting (AOR=3.60, 95% CI=1.74, 7.43). No difference in relapse rates by race were found (AOR=0.57, 95% CI=0.19, 1.72). Alcohol consumption before pregnancy was less among American Indian than white mothers (AOR=0.53 95% CI=0.30, 0.94), and among those who drank no differences by race in drinks/week were observed (AOR for American Indians drinking more than four drinks/week=1.20, 95% CI=0.56, 2.55) or binge drinking (AOR=1.50, 95% CI=0.75, 3.04). Rates of alcohol consumption during pregnancy and topics covered by healthcare providers during prenatal visits did not differ by race. After adjusting for covariates, no differences by race in smoking rates before or during pregnancy were observed and American Indian mothers who smoked were more likely to smoke fewer cigarettes and quit smoking during pregnancy than white mothers. Lower alcohol consumption among American Indian mothers before pregnancy challenges the commonly held belief of elevated alcohol consumption among American Indians compared with other races.

Factores asociados al nivel de ansiedad y de conocimientos sobre puericultura y lactancia de embarazadas primerizas

ObjectiveTo know the level of anxiety and knowledge of childcare and lactation of the current pregnant women, and the clinical-demographic variables with which they are related. DesignCross-sectional study. SettingSeven health centers of Area V (Asturias). ParticipantsFirst-time pregnant women who completed preparatory courses from 01.06.2015 to 31.10.2015, excluding multiple gestation, risk pregnancy, contraindicated breastfeeding and language problems. InterventionsSociodemographic variables questionnaire, STAI state anxiety questionnaire and 23 questions about childcare and lactation. Main measurementsWe performed descriptive and multivariate analysis (program R) of the variables of the questionnaire. ResultsWe captured 104 pregnant women; average age 34.2(SD: 4.5), 94.2% Spanish, 61.5% university, 17.3% smokers in pregnancy, 23.1% with psychopathological antecedents; 88.4% planned to give breastfeeding. The mean STAI-S was 18.1(SD: 7.4) and scored 4.5(SD: 2.3) mean errors. The most faulty ones were on causes of fever (56.7%), fever measurement (54.8%) and physiological stools (55.7%). The multivariate analysis between knowledge and profile showed statistically significant associations with: being foreign, university, pregnancy planning and matron. In relation to the STAI-S was significant for being a smoker, receiving breastfeeding, psychopathological antecedents and matron. ConclusionsThe current pregnant women who complete preparatory courses are mainly mature, university and Spanish. They have good concepts about breastfeeding but many are unaware of basic concepts of fever and stool of the infant. Foreign mothers with unwanted pregnancy and primary education seem to have more confusing concepts. Smoking mothers with psychopathological antecedents and who have not received breastfeeding present more anxiety. The matron significantly influences anxiety and acquired concepts.

P-323 - In vivo investigation on the morphological and functional alterations of RBCs due to active tobacco smoke during pregnancy

Prevalence of smoking during pregnancy risks to adverse outcomes in the mother-child healthcare system. The umbilical cord lacks innervations and thereby the main regulator of its vascular tone and blood flow is the nitric oxide (NO) signaling molecules produced by the endothelial nitric oxide synthase (NOS3). Recent evidences show that red blood cells (RBCs) also possess a functional NOS that synthesize bioactive NO which maintain the rheological properties of RBCs and may play a compensatory role in case of any dysfunction in the cord endothelium. Our study data followed distinct morphological and functional alterations in RBCs isolated from the heavy smoker mothers and their neonates’ cord blood. Immunolabelling showed significant changes in the activation of NOS3, macromolecular damages were developed by 4-hydroxy-2-trans-nonenal staining and lipidometry. Rheological alterations in the RBCs were measured by the Young Modulus parameter using atomic force microscopy. Our molecular and biophysical data outlines the marked effects of maternal smoking on the outcome of in- utero development due to the insufficient supply of O2 which may result in long-lasting (partially to epigenetic alteration) health consequences on the developing fetus.

Effect of Reflexology on Infantile Colic.

The aim of this study was to explore the effect of reflexology on infantile colic. A total of 64 babies with colic were included in this study (n = 31: study group; n = 33: control group). Following a pediatrician's diagnosis, two groups (study and control) were created. Sociodemographic data (including mother's age, educational status, and smoking habits of parents) and medical history of the baby (including gender, birth weight, mode of delivery, time of the onset breastfeeding after birth, and nutrition style) were collected. The Infant Colic Scale (ICS) was used to measure the colic severity in the infants. Reflexology was applied to the study group by the researcher and their mother 2 days a week for 3 weeks. The babies in the control group did not receive reflexology. Assessments were performed before and after the intervention in both groups. The groups were similar regarding sociodemographic background and medical history. While there was no difference between the groups in ICS scores before application of reflexology (p > 0.05), the mean ICS score of the study group was significantly lower than that of control group at the end of the intervention (p < 0.001). Reflexology application for babies suffering from infantile colic may be a promising method to alleviate colic severity.

Tobacco control policies in relation to child health and perinatal health outcomes

The global epidemic of tobacco use continues to cause a considerable burden of premature death and disease.1 2 Worldwide, over 1 billion people are regular smokers, and the societal costs...

The Effects of Prenatal Exposure of Nicotine/Thiocyanate on the Pancreas of 1–Month‐Old Rat Offspring, a Histological Study

BackgroundMaternal cigarette smoking is associated with various adverse effects. This might be associated with impaired pancreatic functions, including the development of pancreatitis, as well as type II diabetes in the offspring of smoking mothers. Nicotine (NC) from cigarette smoke has been linked to several deleterious side effects. Thiocyanate (TCN) present in some body fluids, is consistently related to cigarette smoking, so TCN is being used as a biomarker to check for adult smoking cessation. This study aimed to evaluate the toxic effects of nicotine versus thiocyanate on the pancreas of developing rats.Materials and methodsFifteen pregnant female Sprague Dawley rats were divided into three groups (five rats each): group I, group II, and group III. Group I was considered as the control group; group II was treated with nicotine (6 mg/kg/day subcutaneously from gestation day 4–20); and group III was treated with potassium thiocyanate orally (25 mg/ kg/day from gestation day 4–20). Male offspring of each group were sacrificed after 1 month. Specimens from the pancreatic tail were processed for light microscopic examination.ResultsIn both NC and TCN treated groups, there were congested dilated blood vessels, increase in interlobular connective tissue and infiltration of mononuclear cells. The acini were separated by wide spaces, which may be due to cellular edema. Focal areas of acinar degeneration were found to be completely destroyed leaving empty spaces. Vacuolization of some cells of the acini was found in addition to deficient zymogen granules. Regarding the islets of Langerhans, there was vacuolization of some cells with deeply stained nuclei. These changes were more profound in the nicotine‐treated group than the TCN group.ConclusionThe present study demonstrated that prenatal nicotine administration among substances found in cigarettes, could be responsible for its degenerative changes in the pancreas more than thiocyanate.Support or Funding InformationNo funding was provided for this research.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Prenatal exposure to endocrine disrupting chemicals and risk of being born small for gestational age: Pooled analysis of seven European birth cohorts

Background and aimsThere is evidence that endocrine disrupting chemicals (EDCs) have developmental effects at environmental concentrations. We investigated whether some EDCs are associated with the adverse birth outcome Small for Gestational Age (SGA). MethodsWe used PCB 153, p,p'-DDE, HCB, PFOS and PFOA measured in maternal, cord blood or breast milk samples of 5446 mother-child pairs (subset of 693 for the perfluorinated compounds) from seven European birth cohorts (1997–2012). SGA infants were those with birth weight below the 10th percentile for the norms defined by gestational age, country and infant's sex. We modelled the association between measured or estimated cord serum EDC concentrations and SGA using multiple logistic regression analyses. We explored effect modification by child's sex and maternal smoking during pregnancy. ResultsAmong the 5446 newborns, 570 (10.5%) were SGA. An interquartile range (IQR) increase in PCB 153 was associated with a modestly increased risk of SGA (odds ratio (OR) of 1.05 [95% CI: 1.04–1.07]) that was stronger in girls (OR of 1.09 [95% CI: 1.04–1.14]) than in boys (OR of 1.03 [95% CI: 1.03–1.04]) (p-interaction = 0.025). For HCB, we found a modestly increased odds of SGA in girls (OR of 1.04 [95% CI: 1.01–1.07] per IQR increase), and an inverse association in boys (OR of 0.90 [95% CI: 0.85–0.95]) (p-interaction = 0.0003). Assessment of the HCB-sex-smoking interaction suggested that the increased odds of SGA associated with HCB exposure was only in girls of smoking mothers (OR of 1.18 [95% CI: 1.11–1.25]) (p-interaction = 0.055). Higher concentrations of PFOA were associated with greater risk of SGA (OR of 1.64 [95% CI: 0.97–2.76]). Elevated PFOS levels were associated with increased odds of SGA in newborns of mothers who smoked during pregnancy (OR of 1.63 [95% CI: 1.02–2.59]), while an inverse association was found in those of non-smoking mothers (OR of 0.66 [95% CI: 0.61–0.72]) (p-interaction = 0.0004). No significant associations were found for p,p'-DDE. ConclusionsPrenatal environmental exposure to organochlorine and perfluorinated compounds with endocrine disrupting properties may contribute to the prevalence of SGA. We found indication of effect modification by child's sex and smoking during pregnancy. The direction of the associations differed by chemical and these effect modifiers, suggesting diverse mechanisms of action and biological pathways.

Maternal smoking during pregnancy and the risk of pediatric cardiovascular diseases of the offspring: A population-based cohort study with up to 18-years of follow up

BackgroundCigarette smoke is a well-known reproductive toxicant. We aimed to study the long-term effect of cigarette smoking during pregnancy on the risk for childhood cardiovascular morbidity of the offspring. MethodsA population-based cohort analysis was performed comparing total and subtypes of cardiovascular related pediatric hospitalizations among offspring of smoking mothers versus offspring of non-smoking mothers. The analysis included all singletons born between the years 1999–2014.A Kaplan-Meier survival curve was used to compare the cumulative cardiovascular morbidity, and a Cox proportional hazards model was constructed to adjust for confounders. ResultsThe study population included 242,342 newborns which met inclusion criteria; among them 2861 were born to smoking mothers. Offspring of smoking mothers had higher rates of cardiovascular-related hospitalizations (1.3% vs. 0.6%, OR 2.1, 95% CI 1.5–2.9; p < 0.001; Kaplan-Meier log-rank test p < 0.001). ConclusionSmoking exposure during pregnancy is associated with an increased risk for long-term pediatric cardiovascular morbidity of the offspring.

Placenta structural changes in heavy smoking mothers: a stereological aspect

Objective: Smoking during pregnancy is able to alter the structure and function of the placenta. In the present study, quantitative changes of the placenta in smoking mothers were investigated compared to healthy controls by Cavalieri’s point counting method.Methods: Twenty placentas from heavy smoking mothers and non-smoker controls (n = 10 in each group) were selected. Systematic uniform random sampling (SURS) was used for sample selection and tissue sectioning. Quantitative parameters of the placenta in the selected sections were estimated after Masson’s trichrome staining. Differences between the two groups were determined by the Mann Whitney U test and the significance level was set at p < .05.Results: Results showed that there was a significant difference in the placental weight, total volume of placenta, intervillous space, fibrin and syncytiotrophoblast between the heavy smoker group and the control group (p < .05). The differences in the volume density of fibrin and blood vessels between the smoker and control groups were statistically significant (p < .05).Conclusions: Our findings suggested that quantitative parameters of the placenta significantly changed in placentas from the smoker group compared to controls. These changes can probably be associated with pregnancy complications in smoking mothers and may affect the development and survival of the fetus and even its future life.

Smoking during pregnancy and harm reduction in birth weight: a cross-sectional study

BackgroundDifferent studies have shown the advantages of abstinence from cigarette smoking during pregnancy to promote full fetal development. Given that pregnant women do not always abstain from smoking, this study aimed to analyze the effect of different intensities of smoking on birth weight of the newborn.MethodsA cross-sectional study was adopted to explore smoking in a population of pregnant women from a medium-sized city in São Paulo state, Brazil, who gave birth between January and June of 2012. Data were collected from maternal and pediatric medical files and, where data were absent, they were collected by interview during hospitalization for delivery. For data analysis, the effect of potential confounding variables on newborn birth weight was estimated using a gamma response model. The effect of the identified confounding variables was also estimated by means of a gamma response regression model.ResultsThe prevalence of smoking during pregnancy was 13.4% in the study population. In full-term infants, birth weight decreased as the category of cigarette number per day increased, with a significant weight reduction as of the category 6 to 10 cigarettes per day. Compared with infants born to non smoking mothers, mean birth weight was 320 g lower in infants whose mothers smoked 6 to 10 cigarettes per day and 435 g lower in infants whose mothers smoked 11 to 40 cigarettes per day during pregnancy.ConclusionsBased on the study results and the principle of harm reduction, if a pregnant woman is unable to quit smoking, she should be encouraged to reduce consumption to less than six cigarettes per day.

Diet quality in childhood: the Generation R Study

PurposeWe aimed to evaluate diet quality of 8-year-old children in the Netherlands, to identify sociodemographic and lifestyle correlates of child diet quality, and to examine tracking of diet quality from early to mid-childhood.MethodsFor 4733 children participating in a population-based cohort, we assessed dietary intake using a validated food-frequency questionnaire at a median age of 8.1 years (interquartile range 8.0–8.2) (2011–2014). Based on dietary guidelines, we developed and validated a food-based diet quality score for children consisting of ten components (score 0–10): sufficient intake of vegetables; fruit; whole grains; fish; legumes; nuts; dairy; oils and soft fats; and low intake of sugar-containing-beverages; and high-fat and processed meat.ResultsWe observed a mean (± SD) diet quality score of 4.5 (± 1.2) out of a maximum of 10. On average, intake of legumes, nuts, and oils or soft fats was below recommendations, whereas intake of sugar-containing beverages and high-fat or processed meat was higher than recommended. The main factors associated with higher diet quality were higher maternal educational level (β = 0.29, 95% CI 0.21, 0.37 versus low education), higher household income (β = 0.15, 95% CI 0.05, 0.25 versus low income), no maternal smoking (β = 0.13, 95% CI 0.02, 0.25 versus current smoking), and less screen time (β = 0.31, 95% CI 0.24, 0.38)—all independent of each other. For children with available dietary data at age 1 year (n = 2608), we observed only weak tracking of diet quality from early to mid-childhood (Pearson’s r = 0.19, k = 0.11 for extreme quartiles).ConclusionOverall diet quality of 8-year-old children did not conform to dietary guidelines, especially for children having more screen time, children of lower educated or smoking mothers, or from lower-income households.

Impact of the Social and Natural Environment on Preschool-Age Children Weight.

Background: The complex impact of environmental and social factors on preschool children being overweight/obese is unclear. We examined the associations between the levels of green space exposure and the risk of being overweight/obese for 4–6 year-old children and assessed the impact of maternal education on these associations. Methods: This cross-sectional study included 1489 mother-child pairs living in Kaunas, Lithuania, in 2012–2013. We assessed children overweight/obesity by standardized questionnaires using international body mass index cut-off points, and the level of greenness exposures by satellite-derived normalized difference vegetation index (NDVI) of each child’s home and by the distance to a nearest city park. The maternal education was used as the SES indicator. We used logistic regression models to investigate the strength of the associations. Results: Children from families with poorer maternal education, pathological mother-child relations and smoking mothers, and living in areas with less greenness exposure (NDVI-100 m), had significantly higher odds ratios of being overweight/obese. Lower maternal education and distance to a city park modified the effect of greenness cover level exposure on the risk of children being overweight/obese. Conclusions: Higher greenness exposure in the residential settings has beneficial effects on children’s physical development. The green spaces exposures for psychosocial stress management is recommended as a measure to prevent overweight/obesity among children.

Education and indoor smoking among parents who smoke: the mediating role of perceived social norms of smoking

BackgroundParents with less formal education are more likely to smoke indoors, causing socioeconomic disparity in children’s exposure to second-hand smoke. However, little is known about the roles of social factors in the socioeconomic gradients of indoor smoking. We tested the potential mediating role of perceived smoking norms on the associations between education and indoor smoking among parents who smoke.MethodsIn this cross-sectional study, 822 smoking fathers and 823 smoking mothers, who lived with young children and were members of a Japanese online survey panel, participated. Structural equation modelling tested the mediating effects of perceived descriptive and subjective norms on the association between education and indoor smoking.ResultsPerceived pro-smoking norms, which were more prevalent among less-educated parents, mediated the association between education and indoor smoking. Household smoking status and worksite smoking ban also mediated this association via perceived norms, but only for fathers. Perceived descriptive norms explained 28.5% of the association for fathers and 37.6% for mothers; the corresponding percentages for perceived subjective norms were 9.8% and 26.6%, respectively.ConclusionsPerceived smoking norms, household smoking status, and a worksite smoking ban could be vital targets of a strategy aimed at reducing the socioeconomic disparity in parental home smoking behaviours.

Fenomena perokok wanita di wilayah kerja Puskesmas Tes, Kabuapten Lebong, Provinsi Bengkulu

Purpose: This study aimed to determine the cause and process of women smoking behavior. Method: Phenomenological study conducted involving 15 women who smoked and lived in Tes village, Lebong District of Bengkulu. Data collection through in-depth interviews and participant observation. The validity of this data through in-depth interviews on two public health center staff, and four husbands of the participants.Results: Imitating friends, having smoking mothers, financial independency, increased sensitivity and desire for cigarette smoke smell when pregnant were the reasons women to smoke. They enjoy cigaret after meal and smoked as part of their culture (smoke on the day received salary and celebrations day “uleak”). If they were not smoking they got headaches, bitter mouth and tongue felt thick, and support from husband towards smoking behavior. The study also found that there was no any education about the impacts of smoking. Conclusion: It is indispensable to do health education about the impacts of smoking on health for women and required a special program to help women smokers to stop smoking and prevent non-smoking women from start smoking, such as quit smoking counseling services.

Long-term cardiovascular reprogramming by short-term perinatal exposure to nicotine's main metabolite cotinine.

Gather 'proof-of-concept' evidence of the adverse developmental potential of cotinine (a seemingly benign biomarker of recent nicotine/tobacco smoke exposure). Pregnant C57 mice drank nicotine- or cotinine-laced water for 6 wks from conception (NPRE = 2% saccharin + 100 μg nicotine/mL; CPRE = 2% saccharin + 10 μg cotinine/mL) or 3 wks after birth (CPOST = 2% saccharin + 30 μg cotinine/mL). Controls drank 2% saccharin (CTRL). At 17 ± 1 weeks (male pups; CTRL n = 6; CPOST n = 6; CPRE n = 8; NPRE n = 9), we assessed (i) cardiovascular control during sleep; (ii) arterial reactivity ex vivo; and (iii) expression of genes involved in arterial constriction/dilation. Blood cotinine levels recapitulated those of passive smoker mothers' infants. Pups exposed to cotinine exhibited (i) mild bradycardia - hypotension at rest (p < 0.001); (ii) attenuated (CPRE , p < 0.0001) or reverse (CPOST ; p < 0.0001) BP stress reactivity; (iii) adrenergic hypocontractility (p < 0.0003), low protein kinase C (p < 0.001) and elevated adrenergic receptor mRNA (p < 0.05; all drug-treated arteries); and (iv) endothelial dysfunction (NPRE only). Cotinine has subtle, enduring developmental consequences. Some cardiovascular effects of nicotine can plausibly arise via conversion into cotinine. Low-level exposure to this metabolite may pose unrecognised perinatal risks. Adults must avoid inadvertently exposing a foetus or infant to cotinine as well as nicotine.

States and predictors of postpartum smoking relapse: a population based longitudinal study

Objectives Although more than half of women who smoke attempt to stop smoking after conception, many relapse after delivery. We conducted a population-based longitudinal study to identify the predictors of postpartum smoking relapse.Methods Participants were expectant mothers living in Nagoya city, Japan, who notified Health Centers of their pregnancy from April 2014 to March 2015. A self-administered questionnaire was given to the expectant mothers that includes individual factors in the pregnancy: expectant mother's smoking status, age, marital status, experience of parturition, (mother's and father's) occupations, infertility treatment reception, feelings when pregnancy was confirmed, plans to return to parents' house for delivery, accessibility to help with childcare, household member(s) smoking in the same room, alcohol consumption, and depressive symptoms continuing more than 2 weeks. We followed their smoking status at their children's "3-month-old health check-up" (3 months) and "1-year-and-6-months-old health check-up" (18 months) held in Health Centers until March 2017. The data were analyzed using a combination of Chi-square or Fisher's exact test and logistic regression modeling. The analyses were conducted separately in primiparas and multiparas in addition to all expectant mothers.Results Participants were 24,413 mothers; 18,041 were followed up at 3 months and 14,163 at 18 months. Of the 18,041 mothers at 3 months, 1,031 primiparas and 695 multiparas stopped smoking when they confirmed pregnancy; 89 (8.6%) primiparas and 107 (15.4%) multiparas relapsed at 3 months. Of the 14,163 mothers at 18 months, 789 primiparas and 568 multiparas stopped smoking when they confirmed pregnancy; 155 (19.6%) primiparas and 174 (30.6%) multiparas relapsed smoking at 18 months. As a result of logistic regression modeling, "multiparas," "younger (<25 years old)," "not married (only in multiparas)," "no plan to return to mother's parent's house for delivery," "household member(s) smoking in the same room (only in primiparas)," and "depressive symptoms (only in all mothers and primiparas)" were the predictors of postpartum smoking relapse at 3 months. "Multiparas," "not married (only in all mothers)," "no help with childcare (only in all mothers)," and "household member(s) smoking in the same room" were the predictors of postpartum smoking relapse at 18 months.Conclusion More mothers relapsed with smoking after 3 months than before 3 months. The predictors of postpartum smoking relapse differed between 3 and 18 months. Support to continue smoking cessation was needed for each mother at an appropriate time not only in pregnancy but also after delivery.

Seremban Cohort Study (SECOST): a prospective study of determinants and pregnancy outcomes of maternal glycaemia in Malaysia

IntroductionBoth gestational diabetes mellitus (GDM) and hyperglycaemia less severe than GDM are associated with risk of adverse pregnancy outcomes. We describe the study design of a prospective cohort of pregnant...

Relationship between first trimester vaginal bleeding and the risk of placental abruption

The aim of this study was to analyze influence of first trimester vaginal bleeding on the risk of placental abruption, as well as to assess the relation of first trimester bleeding and perinatal outcome in this patients with placental abruption. The second objective was to assess the connection of first trimester bleeding with low pregnancy-associated plasma protein-A and maternal serum alpha-fetoprotein with placental abruption. This is the first study that evaluated all relations these analytes in placental abruption with first trimester bleeding. Spontaneous, singleton pregnancies with live fetus ≥26 weeks of gestation with placental abruption were divided into two groups based on their prensence of first-trimester bleeding (Group 1) or without (Group 2). Maternal age, parity, smoking habits, body mass index, history of abortion and abruption, levels of pregnancy-associated plasma protein-A and Alpha-fetoprotein were also analyzed and compared. Main outcome measures were, mean gestational age, gender of baby, APGAR scores, birth length and weight and cesarean section rates. A total of 122 patients were included in the study.There were 44 patients accompanied with first trimester bleeding (group 1) and 78 patients without first trimester bleeding (group 2). The neonatal birthweight was significantly lower in first trimester bleeding group. The rate of smoking mother was significantly higher in first trimester bleeding group. Regarding serum maternal biomarkers, pregnancy-associated plasma protein-A≤0.5 and Alpha-fetoprotein ≥2 MOM was significantly higher in first trimester bleeding group.First trimester bleeding should alert clinicians for the signs of later possible complications in addition to low regnancy-associated plasma protein-A(≤0.5 MOM) and higher Alpha-fetoprotein (≥2 MOM) levels. Presence of vaginal bleeding in first trimester are related with poor maternal and fetal outcome at birth in patient with placental abruption.

651: Maternal smoking during pregnancy and the risk of pediatric cardiovascular diseases of the offspring: A population-based cohort study with up to 18-years follow up

Cigarette smoke is a well-known reproductive toxicant, and maternal cigarette smoke exposure was shown to be associated with maternal cardiovascular morbidity. The understanding of the effect of in utero exposure to cigarette smoke on long-term childhood diseases and specifically cardiovascular morbidity is limited. We aimed to study the long-term effect of cigarette smoking during pregnancy on the risk for childhood cardiovascular morbidity of the offspring. A population based cohort analysis was performed comparing total and different subtypes of cardiovascular related pediatric hospitalizations among offspring of smoking mothers versus offspring of non-smoking mothers. The analysis included all singletons born between the years 1999-2014 at a single tertiary regional medical center. Cardiovascular related morbidities included hospitalizations involving a pre-defined set of ICD-9 codes, as recorded in the hospital computerized files. Infants with congenital malformations, multiple gestations, and all perinatal deaths were excluded from the analysis. A Kaplan-Meier survival curve was used to compare the cumulative cardiovascular morbidity, and a Cox proportional hazards model was constructed to adjust for confounders. The study population included 242,342 newborns which met inclusion criteria; among them 2861 were born to mothers who smoke during pregnancy. Offspring of smoking mothers had significantly higher rates of cardiovascular-related hospitalizations in comparison to offspring of non-smoking mothers (1.3% vs. 0.6%, OR 2.1, 95% CI 1.5-2.9; p<0.001; Kaplan-meier survival curve presented in graph). The association remained significant and independent while adjusting for gestational age, maternal age, hypertension and diabetes (Adjusted HR=2.3, 95% CI 1.6-3.1; p<0.001). Smoking exposure during pregnancy is associated with an increased risk for long-term pediatric cardiovascular morbidity of the offspring. Patients should be informed about the long-term consequences of maternal smoking on offspring health, which may facilitate smoking cessation in this population.View Large Image Figure ViewerDownload Hi-res image Download (PPT)