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Mummy Don’t Smoke
Dr P Lakshmi Reddy
Smoking during pregnancy is not only harmful to the mother but also to the unborn child. The association of smoking with chronic lung diseases and cardio vascular diseases are well documented. The risk of miscarriage, ectopic pregnancy, placental abrution, placenta praevia and premature labour are also real.

Effect of Smoking on the Foetal Outcome
Cigarette smoke contains over 2000 different compounds including carbon monoxide, nicotine, hydrogen cyanide, carcinogens and trace elements such as lead, nickel and cadmium. Nicotine and carbon monoxide are two elements which cause the most harmful effects on the foetus during pregnancy. Nicotine crosses the placenta and reduces blood flow to the foetus, which in turn affects the foetal growth and weight. It is also responsible for the increase in heart rate and reduction in baseline heart rate variability. Meanwhile, carbon monoxide decreases foetal oxygenation by forming a compound called carboxyhaemoglobin which reduces oxygen delivery to the foetus, causing foetal hypoxia. You know how you would be right now, without oxygen. Think of how it could be for the unborn baby.

Children born to smoking mothers are more prone to develop infections such as middle ear and upper respiratory infections, and they become ill more frequently. They are also more prone to asthma. Several studies have confirmed that there is an increased incidence of childhood cancers like acute lymphocytic leukaemia and lymphomas with maternal smoking. These children also would have cognitive and learning problems in later life. Some studies have shown that smoking during pregnancy may harm the child’s development and behaviour giving rise to hyperactive disorders like Attention Deficit Hyperactivity Disorder (ADHD). There also is the increased incidence of Sudden Infant Death Syndrome (or crib death) when the baby is between two to four months of age.

According to a new study, smoking during pregnancy is associated with the changes in both maternal and foetal thyroid function. These adverse effects include increased risk of miscarriage, premature birth, low birth weight and Sudden Infant Death Syndrome (crib death). Smoking during pregnancy has been shown to increase Type 2 diabetes in children.

Nicotine also affects the quantity and quality of the mother’s milk. Women who smoke during pregnancy would have low birth weight babies (this is related to premature delivery and growth related babies). Just some data we wish we didn’t know, if those fingers are twitching to light up a fag. Passive Smoking Passive smoking is known to have similar effects as active smoking. When pregnant women and babies are exposed to smokers around them during pregnancy and after birth, they will be inhaling the same smoke with all the harmful substances. It causes irritation of eyes and airways. In children, it increases the risk of pneumonia, bronchitis, coughing, wheezing, asthma attacks and middle ear infections. They also would have increased risk of dental decay. Passive smoking also increases the risk of a rare condition called persistent pulmonary hypertension of the newborn, all these, without you lighting up one.

Paternal Smoking
It is not only the maternal smoking, but preconceptional paternal smoking can also harm the foetus. Paternal smoking increases the risk of childhood cancers, particularly leukaemia and lymphoma. It has also been linked to mental retardation in children.

Smoking is a preventable condition. If both partners are smokers, they should quit smoking before they plan for a pregnancy. If only the husband smokes and if he cannot quit, at least he should avoid smoking inside the house, around the mother and the baby. More than saving some money on healthcare, you can do something to save your baby: the one you looked forward to, all those nine months - or more. Think about it. The question is, is your baby worth more than the cost of your cigarette?
Dr P Lakshmi Reddy is Consultant Obstetrician & Gynaecologist, Apollo Health City, Hyderabad.
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