Smoking during pregnancy – hematological observations in pregnant women and their newborns after delivery
More details
Hide details
Institute of Haematology and Transfusion Medicine, Warsaw, Poland
4th Military Clinical Hospital with Policlinic, Wroclaw, Poland
Institute of Rural Health, Lublin, Poland
Ann Agric Environ Med. 2012;19(4):836–841
Cigarette smoking is a global public health problem. According to the current estimations, more than one billion people worldwide smoke tobacco. The highest prevalence of smoking is observed in Europe and Central Asia. In Poland, nearly a half of males and 1/3 of females are smokers. Information concerning an increase in the prevalence of tobacco smoking among women is alarming. It is estimated that tobacco smoking is the cause of approximately 10% of deaths worldwide. If the present trend maintains itself, in the present 21st century nearly one billion people will prematurely loose their lives due to tobacco smoking. Tobacco smoking by pregnant women additionally exerts a negative effect on the developing foetus. The objective of the study was analysis of haematological parameters of the erythropoietic system in pregnant women and their newborn babies after delivery according to the number of cigarettes smoked daily by the mothers in pregnancy. The studies were based on the questionnaire forms. The studies were carried out in all hospitals in Poland where pregnant women were hospitalized with their newborns on one day in 2010 and 2011. The material for the study were replies to the questions concerning the results of blood tests of mothers and newborns. No significant changes concerning haematological parameters of the erythropoietic system were observed in women after delivery. With respect to newborns, an increase was noted in the level of haemoglobin in the babies of women who, in the third trimester of pregnancy, smoked more than 6 cigarettes daily. The hematocrit value and amount of erythrocytes did not change. The results of the studies showed that tobacco smoking in pregnancy exerts a negative effect on the environment in which the foetus develops, and consequently, on the health of newborn babies.
Cezary Wojtyła   
Institute of Haematology and Transfusion Medicine, Warsaw, Poland
1. WHO. Tobacco or health: a global status report. Geneva, World Health Organization, 1997.
2. Jha P, Chaloupka FJ, Moore J, Gajalakshmi V, Gupta PC, Peck R, et al. Tobacco Addiction. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB et al. Disease Control Priorities in Developing Countries . 2nd ed. Washington (DC): World Bank; 2006.
3. Fagerström K. The epidemiology of smoking: health consequences and benefits of cessation. Drugs. 2002; 62 Suppl 2: 1-9.
4. WHO. The European report on tobacco control policy. WHO European ministerial conference for a tobacco-free Europe; 18-19 2002; Warsaw, Poland; Copenhagen, WHO Regional Office for Europe, 2002.
5. Zatoński W, Przewoźniak K, Sulkowska U, West R, Wojtyła A. Tobacco smoking in countries of the European Union. Ann Agric Environ Med. 2012; 19(2): 181-192.
6. Wojtyła A, Goździewska M, Paprzycki P, Biliński P. Tobacco-related Foetal Origin of Adult Diseases Hypothesis – population studies in Poland. Ann Agric Environ Med. 2012; 19(1): 117-128.
7. Gilmore A, Pomerleau J, McKee M, Rose R, Haerpfer CW, Rotman D, Tumanov S. Prevalence of smoking in 8 countries of the former Soviet Union: results from the living conditions, lifestyles and health study. Am J Public Health. 2004; 94(12): 2177-2187.
8. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3(11): e442.
9. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet. 1997; 349(9064): 1498-1504.
10. Levine R and the What Works Working Group, with Kinder M. Millions Saved: Proven Successes in Global Health. Washington DC: Center for Global Development, 2004.
11. Peto R, Lopez AD. Future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR. Critical issues in global health. San Francisco: Wiley (Jossey-Bass); 2001: 154-161.
12. Meberg A, Hågå P, Sande H, Foss OP. Smoking during pregnancy-hematological observations in the newborn. Acta Paediatr Scand. 1979; 68(5): 731-4.
13. Bureau MA, Shapcott D, Berthiaume Y, Monette J, Blouin D, Blanchard P, Begin R. Maternal cigarette smoking and fetal oxygen transport: a study of P50, 2,3-diphosphoglycerate, total hemoglobin, hematocrit, and type F hemoglobin in fetal blood. Pediatrics. 1983; 72(1): 22-6.
14. Bili H, Mamopoulos M, Tsantali C, Tzevelekis P, Malaka K, Mantalenakis S, Farmakides G. Elevated umbilical erythropoietin levels during labor in newborns of smoking mothers. Am J Perinatol. 1996; 13(2): 85-7.
15. Knottnerus JA, Delgado LR, Knipschild PG, Essed GG, Smits F. Haematologic parameters and pregnancy outcome. A prospective cohort study in the third trimester. J Clin Epidemiol. 1990; 43(5): 461-466.
16. CDC. Reproductive Effects. Surgeon General’s Report – The Health Consequences of Smoking. Atlanta, CDC, 2004.
17. Cornelius MD, Leech SL, Goldschmidt L, Day NL. Prenatal tobacco exposure: is it a risk factor for early tobacco experimentation? Nicotine Tob Res. 2000; 2(1): 45-52.
18. Guyer B, Freedman MA, Strobino DM, Sondik EJ. Annual summary of vital statistics: trends in the health of Americans during the 20th century. Pediatrics. 2000; 106(6): 1307-1317.
19. Martin JA, Hamilton BE, Ventura SJ, Menacker F, Park MM, Sutton PD. Births: final data for 2001. Natl Vital Stat Rep. 2002; 51(2): 1-102.
20. Nilsen ST, Sagen N, Kim HC, Bergsjø P. Smoking, hemoglobin levels, and birth weights in normal pregnancies. Am J Obstet Gynecol. 1984; 148(6):752-758.
21. Denise P, Pasquis P, Duval C, Lefrançois R. P50 values of non smoker and smoker pregnant women. Biomedicine. 1980; 33(2): 49-51.
22. Habek D, Habek JC, Ivanisević M, Djelmis J. Fetal tobacco syndrome and perinatal outcome. Fetal Diagn Ther. 2002; 17(6): 367-71.
23. Zafar I, Mohammad KN, Nisar M, Rashida M, Assadullah, Shumaila B, Mohammad SA. Effect of cigarette smoking on erythrocytes, Leukocytes and Haemoglobin. J Med Sci. 2003; 3(3): 245-250.
24. Helman N, Rubenstein LS. The effects of age, sex and smoking on erythrocytes and leucocytes. Am J Clin Pathol. 1975; 63: 33-44.
25. Dodsworth H, Dean A, Broom G. Effects of smoking and the pill on the blood count. Br J Haematol. 1981; 49(3): 484-8.
26. Machado Jde B, Plínio Filho VM, Petersen GO, Chatkin JM. Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation. BMC Pregnancy Childbirth. 2011; 11: 24.
27. Soothill PW, Morafa W, Ayida GA, Rodeck CH. Maternal smoking and fetal carboxyhaemoglobin and blood gas levels. Br J Obstet Gynaecol. 1996; 103(1):78-82.
28. Pijpers Pijpers L, Wladimiroff JW, McGhie JS, Bom N. Acute effect of maternal smoking on the maternal and fetal cardiovascular system. Early Hum Dev. 1984; 10(1-2): 95-105.
29. Knudsen A. Maternal smoking and the bilirubin concentration in the first three days of life. Eur J Obstet Gynecol Reprod Biol. 1991; 40(2): 123-127.
30. Ernst E, Matrai A, Schmölzl C, Magyarosy I. Dose-effect relationship between smoking and blood rheology. Br J Haematol. 1987; 65(4): 485-487.
31. Garn SM, Shaw HA, McCabe KD. Effect of maternal smoking on hemoglobins and hematocrits of the newborn. Am J Clin Nutr. 1978 Apr; 31(4): 557-558.
32. al-Alawi E, Jenkins D. Does maternal smoking increase the risk of neonatal polycythaemia? Ir Med J. 2000; 93(6): 175-176.
33. Bush PG, Mayhew TM, Abramovich DR, Aggett PJ, Burke MD, Page KR. Maternal cigarette smoking and oxygen diffusion across the placenta. Placenta. 2000; 21(8): 824-833.
34. Linderkamp O, Stadler AA, Zilow EP. Blood viscosity and optimal hematocrit in preterm and full-term neonates in 50- to 500-micrometer tubes. Pediatr Res. 1992; 32(1): 97-102.
35. Mercelina-Roumans PE, Breukers RB, Ubachs JM, van Wersch JW. Hematological variables in cord blood of neonates of smoking and nonsmoking mothers. J Clin Epidemiol. 1996; 49(4): 449-454.
36. Sochaczewska D, Czeszyńska MB, Konefał H, Garanty-Bogacka B. Maternal active or passive smoking in relation to some neonatal morphological parameters and complications. Ginekol Pol. 2010; 81(9): 687-692.
37. West R, Zatonski W, Przewozniak K, Jarvis MJ. Can we trust national smoking prevalence figures? Discrepancies between biochemically assessed and self-reported smoking rates in three countries. Cancer Epidemiol Biomarkers Prev. 2007; 16(4): 820-2.
38. Jeevasankar M, Agarwal R, Chawla D, Paul VK, Deorari AK. Polycythemia in the newborn. Indian J Pediatr. 2008; 75(1): 68-72.