Gebelikte Kullanılan Sigara Dozunun Maternal ve Fetal Sonuçlar ile İlişkisi

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. 

Anahtar Kelimeler

• Gebelik,Sigara,Maternal prognoz

Relationship Between Smoking Doses and Maternal and Fetal Outcomes of Pregnancy

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. 

Anahtar Kelimeler

• Pregnancy,Cigarette,Maternal prognosis

Kaynakça

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