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How Much Smoking is Too Much Smoking for Pregnant Women?: Presented at ERS

By Earl R. Nichols

VIENNA, AUSTRIA -- October 2, 2003 -- There is significantly more damage to infants whose mothers smoked more than 10 cigarettes per day compared with those who smoked fewer than 10 per day, according to a recent study by British investigators.

In a poster presentation here on September 29^th at the 13^th Annual Congress of the European Respiratory Society, Bulend Yuksel, MD, Barnet and Chase Farm Hospitals, London, United Kingdom, pointed out that no amount of smoking is safe during pregnancy, but there is a significant linear increase in the potential damage that is done according to how much the expectant mother smokes.

Infants of women who smoked more than 10 cigarettes a day had significantly lighter birth-weights, had shorter gestation periods, and stayed much longer in neonatal intensive-care units than infants whose mothers smoked fewer than 10 cigarettes a day.

Dr. Yuksel's study was based on records for all infants admitted to his hospital's neonatal intensive-care unit over the course of 1 year (n=279).

Maternal health records revealed that 49 mothers-to-be smoked regularly during pregnancy; among these women, 14 smoked fewer than 10 cigarettes per day, and the balance smoked more than 10 cigarettes per day.

There were no differences between the groups with respect to the mother's ethnic origin or type of delivery. Incidence of intrauterine growth retardation (IUGR) did not differ between the groups.

Infants born to mothers who smoked the most were on average 0.4 kg lighter, however, with a mean birth weight of 2.1 kg compared to 2.5 kg for infants of mothers who smoked the least.

Length of gestation was also shorter among mothers who smoked more: 38 weeks for those who smoked fewer than 10 cigarettes per day compared with 36 weeks for those who smoked more than 10 cigarettes per day.

Length of time required in the neonatal intensive-care unit due to respiratory difficulties was significantly greater for infants of mothers who smoked more than 10 cigarettes per day -- 10 days versus 3 days -- which not only indicates that the infants were in considerable distress and danger during their first 10 days of life, but represents an great strain on the health-care system as well, Dr. Yuksel said.

More health education about smoking should be stressed for pregnant women -- ideally so that they would stop smoking before they became pregnant, and remain smoke-free after pregnancy, Dr. Yuksel noted. He conceded, however, that this sometimes seems like an impossible task, as the risks of smoking, particularly to an unborn child, are well-known, and have been well-publicised for many years, and yet some women continue to smoke during pregnancy.


[Study title: Antenatal cigarette smoking >10 per day is associated with frequent respiratory symptoms of newborns. Abstract 917]

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