Araştırma Makalesi
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Gebelikte Kullanılan Sigara Dozunun Maternal ve Fetal Sonuçlar ile İlişkisi

Yıl 2018, , 31 - 35, 05.03.2018
https://doi.org/10.16948/zktipb.393346

Öz

Amaç:
Sigaranın maternal, fetal ve neonatal olumsuz etkileri bilinmektedir. Biz bu
çalışmada sigaranın günlük kullanım miktarı ile maternal ve perinatal sonuçlar
arasındaki ilişkiyi araştırmayı amaçladık.

Yöntem ve Gereçler:
Bu çalışma 2015 – 2017 yılları arasında Zeynep Kamil Kadın ve Çocuk
Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum
Kliniğinde yapılmıştır. Çalışmaya 1029 sigara içmeyen ve 261 sigara içen gebe
dahil edildi. Hastalar gebelik boyunca içtikleri sigara adedine göre hafif,
orta ve ağır içici olmak üzere sub-gruplara (≤5 adet /gün, 5-15 adet/gün,
>15 adet/gün) ayrıldı. Hastaların demografik özellikleri kaydedildi. Tüm
gebelerde maternal ve perinatal sonuçlar değerlendirildi.

Bulgular:
Sigara içen gebelerin %28.4’ ü günde ≤5 adet sigara, %62.5’i 5-15 adet sigara
ve %9.2’si >15 adet sigara içmekte idi. Yenidoğanın doğum haftası, doğum
ağırlığı, boyu, 1. Dakika apgar skoru ve 5. Dakika apgar skoru sigara içen
gebeler lehine istatistiksel olarak anlamlı oranda düşük bulundu. Sigara içen
gebelerin yenidoğanlarının doğum ağırlığı sigara içmeyen gebelere göre 162 gram
daha düşük bulundu (p<0.0001). Gebelerin doğum şekli ve bebeklerin
cinsiyetleri açısından gruplar arasında anlamlı fark bulunmadı. Sigara içen
gebelerde preeklampsi, erken membran rüptürü (EMR), preterm prematür membran
ruptürü (PPROM), fetal gelişme kısıtlılığı (FGR), intrauterin fetal kayıp ve
yenidoğan yoğum bakım ünitesine yatış oranları sigara içmeyen gebelere göre
istatistiksel anlamda daha fazla saptandı. Subgruplar kendi arasında
karşılaştırıldığında ise >15 adet/gün sigara kullanan gebelerde diğerlerine
göre istatistiksel anlamda daha düşük doğum ağırlığı ve daha yüksek yenidoğan
yoğun bakım ünitesine yatış oranı görülmüştür.







Sonuç:
Çalışmamız, gebelikte maternal sigara kullanımının doza bağlı bir şekilde düşük
doğum ağırlığı ve yenidoğan yoğun bakım ünitesine yatış riskini artırdığını
göstermiştir. 

Kaynakça

  • 1- Committee on Health Care for Underserved Women. Committee opinion number 503: tobacco use and women’s health. Obstet Gynecol.2011;118(3):746–50.
  • 2- Balkaya N.A. Vural G. Eroğlu K. Gebelikte Belirlenen Risk Faktörlerinin Anne ve Bebek Sağlığı Açısından Ortaya Çıkardığı Sorunların İncelenmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2014;4(1): 6-16.
  • 3- Abel EL. Smoking during pregnancy: a review of effects on growth and development of the offspring. Human Biology 1980;52(4):593-625.
  • 4- Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, Job-Spira N. Risk factors of ectopic pregnancy: a comprehensive analysis based on a large case-control population based study in France. Am J Epidemol 2003;157(3):185-94.
  • 5- Walsh RA Effects of maternal smoking on adverse pregnancy outcomes: examination of the criteria of causation. Hum Biol. 1994;66(6):1059-92.
  • 6- Andres RL The association of cigarette smoking with placenta previa and abruptio placentae. Semin Perinatol. 1996;20(2):154-9.
  • 7- Agrawal A, Scherrer JF, Grant JD, Sartor CE, Pergadia ML, Duncan AE, Madden PA, Haber JR, Jacob T, Bucholz KK, Xian H. The effects of maternal smoking during pregnancy on offspring outcomes. Prev Med. 2010;50(1-2):13-8.
  • 8- Högberg L,Cnattingius S. The influence of maternal smoking habits on the risk of subsequent stillbirth: is there a causal relation? BJOG 2007;114(6): 699–704.
  • 9- Sopori M. Effects of cigarette smokes on the immune system. Nat Rev Immunol 2002;2(5):372-377.
  • 10- Hafström O, Milerad J, Sandberg KL, Sundell HW. Cardiorespiratory effects of nicotine exposure during development. Respir Physiol Neurobiol. 2005;149(1-3):325-41.
  • 11- Riedel C, Schönberger K, Yang S, Koshy G, Chen YC, Gopinath B et al. Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking: a meta-analysis. Int J Epidemiol. 2014;43(5):1593-606.
  • 12- Virtanen HE, Sadov S, Toppari J. Prenatal exposure to smoking and male reproductive health. Curr Opin Endocrinol Diabetes Obes. 2012;19(3):228-32.
  • 13- Huang SH, Weng KP, Huang SM, Liou HH, Wang CC, Ou SF, Lin CC, Chien KJ, Lin CC, Wu MT. The effects of maternal smoking exposure during pregnancy on postnatal outcomes: A cross sectional study. J Chin Med Assoc 2017;80(12):796-802.
  • 14- Berlin I, Golmard JL, Jacob N, Tanguy ML, Heishman SJ. Cigarette Smoking During Pregnancy: Do Complete Abstinence and Low Level Cigarette Smoking Have Similar Impact on Birth Weight? Nicotine Tob Res. 2017;19(5):518-524.
  • 15- Spracklen CN, Ryckman KK, Harland K, Saftlas AF. Effects of smoking and preeclampsia on birth weight for gestational age. J Matern Fetal Neonat Med 2015;28(6):679-684.
  • 16- Newman MG, Lindsay MK, Graves W. Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes. J Matern Fetal Neonat Med 2001;10(3):166-170.
  • 17- Shobeiri F, Jenabi E. Smoking and placenta previa: a meta-analysis. J Matern Fetal Neonat Med 2017; 30(24):2985-2990.
  • 18- Lambers DS, Clark KE. The maternal and fetal physiologic effects of nicotine. Semin Perinatol 1996;20(2):115-126.
  • 19- Mantzoros CS, Varvarigou A, Kaklamani VG, Beratis NG, Flier JS. Effect of birth weight and maternal smoking on cord blood leptin concentrations of full-term and preterm newborns. J Clin Endocrinol Metab. 1997;82(9):2856-61.
  • 20- Bernstein IM, Mongeon JA, Badger GJ, Solomon L, Heil SH, Higgins ST. Maternal smoking and its association with birth weight. Obstet Gynecol. 2005;106(5 pt.1):986-991.
  • 21- England LJ, Kendrick JS, Wilson HG, Merritt RK, Gargiullo PM, Zahniser SC. Effects of smoking reduction during pregnancy on the birth weight of term infants. Am J Epidemiol 2001;154(8):694-701.
  • 22- Ko TJ, Tsai LY, Chu LC, Yeh SJ, Leung C, Chen CY, Chou HC, Tsao PN, Chen PC, Hsieh WS. Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: a birth cohort study. Pediatr Neonatol 2014;55(1):20-27.
  • 23- Kramer MS. Determinants of low birthweight: methodological assessment and metaanalysis. Bulletin of the World Health Organization 1987; 65(5):663-737.
  • 24- Berkowitz GS, Papiernik E. Epidemiology of preterm birth. Epidemiologic Reviews 1993;15(2):414-443.
  • 25- Shah NR, Bracken MB. A systematic review and metaanalysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol 2000;182(2):465–472.
  • 26- Horta BL, Victora CG, Menezes AM, Halpern R, Barros FC. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol 1997;11(2):140-151.
  • 27- Chiolero A, Bovet P, Paccaud F. Association between maternal smoking and low birth weight in Switzerland: the EDEN study. Swiss Med Wkly. 2005;135(35-36):525-530.
  • 28- Blatt K, Moore E, Chen A, Van Hook J, DeFranco EA. Association of reported trimester-specific smoking cessation with fetal growth restriction. Obstet Gynecol. 2015;125(6):1452-1459.

Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy

Yıl 2018, , 31 - 35, 05.03.2018
https://doi.org/10.16948/zktipb.393346

Öz

Introduction: We
aimed to investigate the relationship between daily smoking doses and maternal
and perinatal outcomes.

Methods: This
study was conducted between 2015 and 2017 in Zeynep Kamil Women's and Children's
Hospital Education and Research Hospital. 1029 pregnancies who did not smoke
and 261 pregnancies who smoked were included in the study. Patients were
divided into subgroups (≤5 pcs / day, 5-15 pcs / day,> 15 pcs / day), which
were mild, moderate and heavy smokers. Demographic characteristics of the
patients were recorded. All maternal and perinatal outcomes were evaluated.

Results:  28.4% of the smokers were
using ≤5 cigarettes per day, 62.5% of the smokers were using 5-15 cigarettes
and 9.2% of the smokers were using> 15 cigarettes. Birth weight, gestational
week of birth, birth height, 1st minute apgar scores and 5th minute apgar
scores were statistically significantly lower in pregnancies who smoked. The
birth weight of smokers was 162 grams lower than pregnancies who did not smoke
(p <0.0001). There was no significant difference between the groups regards
to type of delivery and the sex of the infants. Rates of preeclampsia,
premature rupture of membranes (PPROM), fetal growth restriction (IUGR), intrauterine
fetal demise and neonatal care unit admission were statistically significantly
higher in pregnancies who smoked. When subgroups were compared, pregnancies who
smoked > 15 cigarettes per day were found to have statistically
significantly lower birth weight and higher rates of neonatal intensive care
unit admission.







Conclusion:
Our study revealed that the risk of low birth weight and risk of admission to
the neonatal intensive care unit increased with increasing cigarette usage
during pregnancy. 

Kaynakça

  • 1- Committee on Health Care for Underserved Women. Committee opinion number 503: tobacco use and women’s health. Obstet Gynecol.2011;118(3):746–50.
  • 2- Balkaya N.A. Vural G. Eroğlu K. Gebelikte Belirlenen Risk Faktörlerinin Anne ve Bebek Sağlığı Açısından Ortaya Çıkardığı Sorunların İncelenmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2014;4(1): 6-16.
  • 3- Abel EL. Smoking during pregnancy: a review of effects on growth and development of the offspring. Human Biology 1980;52(4):593-625.
  • 4- Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, Job-Spira N. Risk factors of ectopic pregnancy: a comprehensive analysis based on a large case-control population based study in France. Am J Epidemol 2003;157(3):185-94.
  • 5- Walsh RA Effects of maternal smoking on adverse pregnancy outcomes: examination of the criteria of causation. Hum Biol. 1994;66(6):1059-92.
  • 6- Andres RL The association of cigarette smoking with placenta previa and abruptio placentae. Semin Perinatol. 1996;20(2):154-9.
  • 7- Agrawal A, Scherrer JF, Grant JD, Sartor CE, Pergadia ML, Duncan AE, Madden PA, Haber JR, Jacob T, Bucholz KK, Xian H. The effects of maternal smoking during pregnancy on offspring outcomes. Prev Med. 2010;50(1-2):13-8.
  • 8- Högberg L,Cnattingius S. The influence of maternal smoking habits on the risk of subsequent stillbirth: is there a causal relation? BJOG 2007;114(6): 699–704.
  • 9- Sopori M. Effects of cigarette smokes on the immune system. Nat Rev Immunol 2002;2(5):372-377.
  • 10- Hafström O, Milerad J, Sandberg KL, Sundell HW. Cardiorespiratory effects of nicotine exposure during development. Respir Physiol Neurobiol. 2005;149(1-3):325-41.
  • 11- Riedel C, Schönberger K, Yang S, Koshy G, Chen YC, Gopinath B et al. Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking: a meta-analysis. Int J Epidemiol. 2014;43(5):1593-606.
  • 12- Virtanen HE, Sadov S, Toppari J. Prenatal exposure to smoking and male reproductive health. Curr Opin Endocrinol Diabetes Obes. 2012;19(3):228-32.
  • 13- Huang SH, Weng KP, Huang SM, Liou HH, Wang CC, Ou SF, Lin CC, Chien KJ, Lin CC, Wu MT. The effects of maternal smoking exposure during pregnancy on postnatal outcomes: A cross sectional study. J Chin Med Assoc 2017;80(12):796-802.
  • 14- Berlin I, Golmard JL, Jacob N, Tanguy ML, Heishman SJ. Cigarette Smoking During Pregnancy: Do Complete Abstinence and Low Level Cigarette Smoking Have Similar Impact on Birth Weight? Nicotine Tob Res. 2017;19(5):518-524.
  • 15- Spracklen CN, Ryckman KK, Harland K, Saftlas AF. Effects of smoking and preeclampsia on birth weight for gestational age. J Matern Fetal Neonat Med 2015;28(6):679-684.
  • 16- Newman MG, Lindsay MK, Graves W. Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes. J Matern Fetal Neonat Med 2001;10(3):166-170.
  • 17- Shobeiri F, Jenabi E. Smoking and placenta previa: a meta-analysis. J Matern Fetal Neonat Med 2017; 30(24):2985-2990.
  • 18- Lambers DS, Clark KE. The maternal and fetal physiologic effects of nicotine. Semin Perinatol 1996;20(2):115-126.
  • 19- Mantzoros CS, Varvarigou A, Kaklamani VG, Beratis NG, Flier JS. Effect of birth weight and maternal smoking on cord blood leptin concentrations of full-term and preterm newborns. J Clin Endocrinol Metab. 1997;82(9):2856-61.
  • 20- Bernstein IM, Mongeon JA, Badger GJ, Solomon L, Heil SH, Higgins ST. Maternal smoking and its association with birth weight. Obstet Gynecol. 2005;106(5 pt.1):986-991.
  • 21- England LJ, Kendrick JS, Wilson HG, Merritt RK, Gargiullo PM, Zahniser SC. Effects of smoking reduction during pregnancy on the birth weight of term infants. Am J Epidemiol 2001;154(8):694-701.
  • 22- Ko TJ, Tsai LY, Chu LC, Yeh SJ, Leung C, Chen CY, Chou HC, Tsao PN, Chen PC, Hsieh WS. Parental smoking during pregnancy and its association with low birth weight, small for gestational age, and preterm birth offspring: a birth cohort study. Pediatr Neonatol 2014;55(1):20-27.
  • 23- Kramer MS. Determinants of low birthweight: methodological assessment and metaanalysis. Bulletin of the World Health Organization 1987; 65(5):663-737.
  • 24- Berkowitz GS, Papiernik E. Epidemiology of preterm birth. Epidemiologic Reviews 1993;15(2):414-443.
  • 25- Shah NR, Bracken MB. A systematic review and metaanalysis of prospective studies on the association between maternal cigarette smoking and preterm delivery. Am J Obstet Gynecol 2000;182(2):465–472.
  • 26- Horta BL, Victora CG, Menezes AM, Halpern R, Barros FC. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol 1997;11(2):140-151.
  • 27- Chiolero A, Bovet P, Paccaud F. Association between maternal smoking and low birth weight in Switzerland: the EDEN study. Swiss Med Wkly. 2005;135(35-36):525-530.
  • 28- Blatt K, Moore E, Chen A, Van Hook J, DeFranco EA. Association of reported trimester-specific smoking cessation with fetal growth restriction. Obstet Gynecol. 2015;125(6):1452-1459.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Çiğdem Yayla Abide

Ebru Çoğendez

Pınar Kumru

Evrim Bostancı Ergen

Çetin Kılıççı

Yayımlanma Tarihi 5 Mart 2018
Yayımlandığı Sayı Yıl 2018

Kaynak Göster

APA Yayla Abide, Ç., Çoğendez, E., Kumru, P., Bostancı Ergen, E., vd. (2018). Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy. Zeynep Kamil Tıp Bülteni, 49(1), 31-35. https://doi.org/10.16948/zktipb.393346
AMA Yayla Abide Ç, Çoğendez E, Kumru P, Bostancı Ergen E, Kılıççı Ç. Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy. Zeynep Kamil Tıp Bülteni. Mart 2018;49(1):31-35. doi:10.16948/zktipb.393346
Chicago Yayla Abide, Çiğdem, Ebru Çoğendez, Pınar Kumru, Evrim Bostancı Ergen, ve Çetin Kılıççı. “Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy”. Zeynep Kamil Tıp Bülteni 49, sy. 1 (Mart 2018): 31-35. https://doi.org/10.16948/zktipb.393346.
EndNote Yayla Abide Ç, Çoğendez E, Kumru P, Bostancı Ergen E, Kılıççı Ç (01 Mart 2018) Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy. Zeynep Kamil Tıp Bülteni 49 1 31–35.
IEEE Ç. Yayla Abide, E. Çoğendez, P. Kumru, E. Bostancı Ergen, ve Ç. Kılıççı, “Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy”, Zeynep Kamil Tıp Bülteni, c. 49, sy. 1, ss. 31–35, 2018, doi: 10.16948/zktipb.393346.
ISNAD Yayla Abide, Çiğdem vd. “Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy”. Zeynep Kamil Tıp Bülteni 49/1 (Mart 2018), 31-35. https://doi.org/10.16948/zktipb.393346.
JAMA Yayla Abide Ç, Çoğendez E, Kumru P, Bostancı Ergen E, Kılıççı Ç. Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy. Zeynep Kamil Tıp Bülteni. 2018;49:31–35.
MLA Yayla Abide, Çiğdem vd. “Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy”. Zeynep Kamil Tıp Bülteni, c. 49, sy. 1, 2018, ss. 31-35, doi:10.16948/zktipb.393346.
Vancouver Yayla Abide Ç, Çoğendez E, Kumru P, Bostancı Ergen E, Kılıççı Ç. Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy. Zeynep Kamil Tıp Bülteni. 2018;49(1):31-5.