Smoking in pregnancy
What are the likely effects of smoking during pregnancy?
There is no doubt that smoking is bad for your pregnancy. Among the likely adverse effects of this habit are spontaneous miscarriage, low birth-weight, bleeding conditions in pregnancy (APH), and increase in the perinatal mortality (the death of the baby just before or soon after birth).
Why is smoking in pregnancy harmful?
When you smoke, you are sending nicotine, carbon monoxide and cyanide into your circulation. These act to reduce oxygen supply to the growing baby. The higher the amount of nicotine in the cigarette brand you smoke and the higher the number of cigarettes smoked daily, the higher the risk of adverse effects.
No rate of smoking is considered completely safe.
Why would smoking increase the risk of bleeding complication in pregnancy?
It is a direct effect of the reduced oxygenation of the afterbirth. The two major causes of bleeding in pregnancy which are placental abruption and placenta praevia are both more common among smokers. Both these complications can lead to fetal loss, with placental abruption being riskier.
Why is low birth-weight so bad?
This is a direct result of the fetus being subjected to chronic oxygen starvation. It increases the risk of death or illness at birth. A small fetus copes less well with the stresses and strains of labour and this increases the risk of emergency caesarean section.
Why is baby loss higher among mothers who smoke?
Death of the baby at or just before birth is twice as high among mothers who smoke in pregnancy compared to those who do not.
These babies are lost as a result of an increase in complications such as severe bleeding in pregnancy, preterm delivery and preterm rupture of membranes, all of which could be a direct consequence of smoking.
Surely spontaneous miscarriage cannot be blamed on smoking?
Rates of spontaneous miscarriage are over 25 per cent higher among smokers and, in England and Wales alone, over 4000 miscarriages are directly blamed on maternal smoking every year.
It is thought that in the older mother (over 35 years of age), smoking may increase the risk of chromosomal anomalies, which in turn increases the risk of miscarriage further still.
Is the mother who smokes out of the woods once she has delivered safely?
Unfortunately not. Cot death (sudden infant death syndrome or SIDS) has been partly blamed on parental smoking. The risk of this happening to the baby of a mother who smokes is calculated to be increased two to five times compared to those in non-smoking households. In fact, a quarter of all cot deaths are directly attributable to maternal smoking, especially if death occurs in the first ten weeks of life.
Are there any long-term effects of smoking in pregnancy?
Children born to smokers on average suffer more from poor physical and intellectual growth. In fact, the latter is quite marked and study after study has shown that educational attainment is significantly lower for those children whose mothers smoked during pregnancy and after birth. On the physical front, though less marked, they achieve lower weight and height.
Is it beneficial to stop smoking during pregnancy?
Yes. The damage from smoking is cumulative. When you stop smoking, you halve the damage. Obviously, the earlier you stop, the bigger the benefit to your baby.
Moreover, since smoking has all sorts of health problems for pregnant women as well, pregnancy is a good time to quit smoking permanently. Certainly, the incentive is bigger. In the UK, about 30 per cent of smoking mothers manage to stop smoking during pregnancy. Over half of these stay off cigarettes permanently.
What is the advice regarding anti-smoking medication such as Chantix (Varenicline) use in pregnancy?
Chantix use is not advised in pregnancy. There is evidence of adverse effect on the fetus which makes it unsuitable during this period. This advice extends to the postnatal period if the mother is breast-feeding