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Effect of passive smoking in pregnancy on neonatal nucleated red blood cells
S Dollberg1, O Fainaru, F B Mimouni
1Department of Neonatology, the Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Insights
Infants born to mothers exposed to passive smoking during pregnancy had higher nucleated red blood cell (RBC) counts at birth. This suggests potential negative impacts on fetal oxygenation, highlighting the importance of avoiding environmental tobacco smoke exposure.
Area of Science:
- Neonatal physiology
- Environmental health
- Obstetrics
Background:
- Maternal smoking is a known risk factor for adverse pregnancy outcomes.
- The effects of passive smoke exposure on fetal development are less understood.
- Nucleated red blood cells (RBCs) are indicators of fetal stress and oxygenation.
Purpose of the Study:
- To determine if passive smoking during pregnancy is associated with elevated nucleated RBC counts in term, appropriate for gestational age (AGA) infants at birth.
- To investigate the potential impact of maternal passive smoke exposure on fetal oxygenation.
Main Methods:
- A comparative study design was used, analyzing absolute nucleated RBC counts in newborns within the first 12 hours of life.
- Two groups of term, vaginally delivered infants were compared: those born to mothers with routine passive smoke exposure during pregnancy and those born to non-exposed mothers.
- Infants born to mothers with conditions known to affect nucleated RBC counts were excluded to ensure accurate comparison.
Main Results:
- No significant differences were observed in birth weight, maternal age, parity, or Apgar scores between the groups.
- Infants exposed to passive smoking had a higher median absolute nucleated RBC count (357 x 10^6/L) compared to the non-exposed group (237 x 10^6/L).
- Statistical analysis confirmed that passive smoking status was the only significant independent predictor of elevated nucleated RBC counts.
Conclusions:
- Term AGA infants born to mothers exposed to passive smoking exhibit increased circulating nucleated RBC counts at birth.
- These findings suggest that passive smoking during pregnancy may have subtle adverse effects on fetal oxygenation.
- Avoiding passive smoke exposure during pregnancy is recommended to mitigate potential negative fetal outcomes.
Objective:
We evaluated whether the absolute nucleated red blood cell (RBC) count is elevated in term, appropriate for gestational age (AGA) infants born to women exposed to passive smoking in pregnancy.
Patients And Methods:
We compared absolute nucleated RBC counts taken during the first 12 hours of life in 2 groups of term, vaginally delivered infants, 1 group born to mothers who were routinely exposed to tobacco smoke during pregnancy (n = 55) either at home or at the workplace, and the other to mothers who were not routinely exposed to any tobacco smoke (n = 31). We excluded infants of women with conditions known to elevate nucleated RBC counts.
Results:
There were no differences between groups in birth weight, maternal age, gravidity, parity, maternal analgesia during labor, 1- and 5-minute Apgar scores. Gestational age was minimally higher in the control group (39.6 +/- 1.1 vs 39.2 +/-.8 weeks). The median absolute nucleated RBC count in the passive smoking group was 357 x 10(6)/L (range: 0-5091 x 10(6)/L) versus 237 x 10(6)/L (range: 0-1733 x 10(6)/L) in nonsmoking controls. Stepwise regression analysis that included Apgar scores, gestational age, and the passive smoking status (yes/no) as independent variables showed significant correlation of absolute nucleated RBC count only with the passive smoking status.
Conclusion:
At birth, term AGA infants born to mothers exposed to passive smoking have increased circulating absolute nucleated RBC counts compared with those of controls. We speculate that passive smoking in pregnancy should be avoided, because it may have subtle negative effects on fetal oxygenation.