Smoking
during pregnancy
Sir,
The
feeling of motherhood is a
dream of every woman which she cherishes
throughout her life and nourishes with
her blood and blessing during the span of
nine months. Her joy is further enhanced
when the baby born is healthy and with
out any ailment. A healthy baby is a Gods
gift not only to the parents but also to
the entire nation, as a healthy child
represents a healthy nation. Since the
growth and development of fetus from a
tiny cell at conception (zygote) to a
full term baby of approximately 71bs
takes place with in mother’s body,
it is also mostly affected by maternal
environment. The maternal factors, which
determine the fate of her child, include
her age, weight, nutritional status, diet
during pregnancy, inter-pregnancy
intervals, parity etc. Apart from
physical and psychological environment of
the mother, maternal habits during
pregnancy also have a direct bearing on
the health of her child. Good habits have
positive effect while bad ones have
proven to be detrimental. One of such
habits includes smoking by mothers during
pregnancy. It is also a traditional habit
supported by society in some parts of
J&K because of which large number of
people smoke hukkas.
Smoking
during pregnancy is an act of knowingly
disregarding the well being of child, the
expecting mother is carrying in her womb.
The most consistently observed effect of
smoking on the prenatal development is
reduction in the birth-weight of the
infant. An average new born at birth
weighs about 71bs (approx. 3.4 kgs) while
in case of smoking mothers the reduction
in fetal weight is about 220g-250g which
is often dose related i.e. number of
cigarettes smoked per day.
The
harmful effect of smoking on the course
of pregnancy is principally the result of
carbon monoxide (co) to which the fetus
is exposed. The carbon monoxide from the
incomplete oxidation of tobacco is
carried in the maternal blood to the
placenta where it diffuses across the
placental barrier and enters the fetal
blood to form fetal carboxy-haemoglobin
with the fetal hemoglobin. As a result of
this smokers have 10% reduction in their
oxygen carrying capacity. This vascular
constriction reduces the blood flow to
the placenta and interferes with the
fetal nutrient delivery system.
This
detrimental effect of smoking on fetal
health has been confirmed by many studies
carried all over the world. A
longitudinal study carried out by
Patricia Shiono and Klebanoff (1980)
concluded that in comparison to pregnant
woman who do not smoke, those who smoke a
packet a day or more have 20% greater
chance of delivering their baby at 37th
week of gestation or earlier and 60%
greater chances of delivering at 33 weeks
of gestation or earlier, thus giving
birth to both low birth-weight and
premature babies.
Jacobson
et al (1980) while carrying studies on
birth weight of children found that most
observed effect of smoking on prenatal
development is reduced birth weight of
infant. They found a difference of 200gm
the birth weight of infant born to
smoking mothers, which resulted from
lowered placental blood flow as nicotine
constricts blood vessels.
Several
studies have shown that woman who smoke
round the time of conception have nearly
double the chances of ectopic pregnancy
when compared to non-smokers. Smoking
during pregnancy reduces fetal chest
breathing, restricts fetal blood supply
and increases the mother’s risk of
respiratory track infection and can also
cause- miscarriage.
In
addition to the effect of smoking on
birth weight and skeletal growth, Luke et
al for the first time demonstrated the
reduction of head growth as a result of
maternal smoking.
While
studying the role of cigarette smoking
and psychological stress in pregnancy
weight gain, the university of
Connecticut (1982) found that cigarette
smoking and stress might cause low weight
gain by reducing the utilization of
calories.
Further,
smokers requires almost twice as much
more vitamin C concentration. Also serum
levels of carotenes, vitamins and Zinc
tend to be lower in smokers, which result
in low weight of their babies.
On the
occasion of "No smoking
day" it is therefore important for
all of us to create awareness among
masses, especially the rural and tribal
areas where smoking by women is socially
sanctioned, about the deleterious impact
of smoking on their babies. This is
important since in this endeavor, we are
trying to save not one but two lives out
of clutches of tobacco.
Yours
etc...
Dr. Rajni Dhingra
& Asiya Mushtaq
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