Fetal cardiovascular system as influenced by maternal smoking

Primary prevention of atherosclerosis should be initiated early in life, preferably in childhood. Nevertheless, it tends to be forgotten that a child has existed for nine months before birth, and that the newborn child might already have been exposed to agents capable of causing vessel damage. Studies of the umbilical artery, umbilical vein, and vessels of the placental villi (2, 3, 4, 5, 6) revealed that, in this portion of the fetal cardiovascular system, severe damage to the vessel wall is associated with maternal tobacco smoking during pregnancy. These alterations within the fetal cardiovascular system were never found in the children of non-smoking mothers. If similar changes occur in the other vessels of the newborn child, which it seems reasonable to expect, they might give rise to sequelae later in life. It should therefore strongly be advocated that pregnant women abandon tobacco smoking.