Reuters Photojournalism
Our day's top images, in-depth photo essays and offbeat slices of life. See the best of Reuters photography. See more | Photo caption
The Afghan Army
The many faces of the Afghan National Army, which has taken over security of the country from NATO. Slideshow
Sponsored Links
Mom's smoking ups risk of heart defects in baby
This handout image, released on November 10, 2010 depicts a mother blowing cigarette smoke in a child's face in one of the Federal Drug Administration's proposed new ''graphic health warnings.''
Credit: Reuters/HHS/Handout
NEW YORK |
NEW YORK (Reuters Health) - Mothers who smoke during the first trimester of pregnancy are more likely to give birth to babies with some of the most common types of birth defects, a new study finds.
Specifically, women who smoked early in pregnancy were 30 percent more likely to give birth to babies with obstructions in the flow of blood from the heart to the lungs, and nearly 40 percent more likely to have babies with openings in the upper chambers of their hearts.
"For women who are planning to become pregnant, if they are smokers, they should stop smoking," study author Dr. Adolfo Correa of the Centers for Disease Control and Prevention (CDC) told Reuters Health. And if they find out they are pregnant, "they should stop smoking right away."
These findings add to previous evidence that suggested smoking may increase the risk of some congenital heart defects, the most common type of birth defects.
To investigate further, Correa and his team reviewed information collected from mothers of 2,525 infants with congenital heart defects and mothers of 3,435 similar infants who were born with healthy hearts.
Correa and his team focused on two types of heart defects already linked to smoking in pregnancy - obstructions in blood flow from the right side of the heart to the lungs and openings between the upper chambers of the heart.
These abnormal openings in the heart's upper chambers occur in roughly one out of every 1,000 babies in the general population, Correa noted. The obstructions in blood flow to the lungs are slightly less common, occurring at a rate of 0.6 per 1,000 babies in the U.S., he said.
Based on his results, if moms choose to smoke during pregnancy, those rates increase - women who smoked during early pregnancy were 36 percent more likely to have a baby with these abnormal openings, and 32 percent more likely to have a baby born with this type of obstruction in blood flow to the lungs.
The findings appear in the journal Pediatrics.
Smoking in the second and third trimesters may also pose risks to the unborn baby, Correa noted, but he and his colleagues focused on the first trimester because this is the time when most organs are being developed, and the fetus is "most susceptible to the effects of environmental conditions." But this is also the time when women are least likely to know they are pregnant, making it even more imperative they stop smoking before any chance of pregnancy occurs, he added.
It's not clear how smoking may affect heart development, Correa noted - it might somehow lower levels of folate, known to prevent birth defects. "We don't really know the mechanism for how smoking might be associated with heart defects," he said.
Heart problems aren't the only risk to babies associated with smoking in pregnancy, he said - moms who maintain the unhealthy habit are also more likely to have pre-term or very small babies and to have babies born with cleft lip and palate.
Overall, 40,000 babies are born with some type of congenital heart defect every year, according to the CDC.
A news release from the CDC adds that this study and other research suggest that if women quit smoking before or very early in pregnancy, they could avoid as many as 100 cases of the obstruction type of heart defect and 700 cases of abnormal openings in the upper heart chambers each year in the United States.
SOURCE: bit.ly/gqRoVW Pediatrics, online February 28, 2011.
- Tweet this
- Link this
- Share this
- Digg this
- Reprints
The quote is from the Correa paper; note the word ‘modest’ risk and the word ‘implicates’. Smoking is implicated because certain mothers whose infants were born with CHD(s)smoked during their pregnancy. However, what is unknown is what other factors may have influenced the congenatal defects in the infants. Even the lead researcher cannot explain what of the cigarette component may be responsible and how that triggers the malformation of the fetal heart. The figures given don’t give an idea of how many infants, if any, had multiple malformations; and if there were multiple combinations,what the combinations were and of what severity (ie, what were tha chances the infant would live or die given the malformation(s)observed.) Also, the figures listed in the paper do not add up to 30%-except in one type of CHD. It might be more accurate to say that the study suggests a correlation between smoking and congenital heart defects, which is probably true; however, to suggest that smoking is the only factor is not only bad research and bad medicine it is bad journalism, not to mention that if a mother who has had the misfortune to give birth to a child with CHS reads this, she may suffer psychological trauma—in short, have a guilt trip.
Only in reading the actual paper does one know that the data used in the report is at least 25 years old…and taken from mothers who presumably spent their pregancy in Baltimore, MD-a city full of polluted air and contaminated water during those years or, spent it in the DC area, an area which was just as polluted. That pollution was inhaled along with the noxious smoke from the tobacco they may have smoked.
Generally speaking one finds what one seeks, which makes me wonder how much bias was built in from the researchers. But I suspect that there are other contributing factors besides just the cigarette smoke.
And by the way, long before that sudy was done and long before that data was collected, I was the mother of a daughter who was born with 11 major cardiac anomalies. Despite the heartache (no pun intended) and the multi-medical disciplines which were her short life, I would not trade the few months I had her in my life for all the tea from anywhere.
For the mothers who have or have had the misfortune to have a child with CHD, you have my empathy and sympathy. But don’t let the diagnosis or the procedures overwhelm you; and above all, don’t let the disease overshadow the fact that your child is in need of all the love you can provide. He or she is, afterall, your child.
http://www.ncbi.nlm.nih.gov/pubmed/11721483
Follow Reuters