This Article Full Text Full Text (PDF) All Versions of this Article: 90/5/2556    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pringle, P. J. Articles by Hindmarsh, P. C. Search for Related Content PubMed PubMed Citation Articles by Pringle, P. J. Articles by Hindmarsh, P. C. Related Collections Pediatric Endocrinology

The Influence of Cigarette Smoking on Antenatal Growth, Birth Size, and the Insulin-Like Growth Factor Axis

Centre for Human Growth and Maturation at the London Centre for Paediatric Endocrinology and Metabolism (P.J.P., S.K.-K., P.C.H.) and Department of Obstetrics and Gynaecology (C.H.R.), University College London, London W1T 3AA, United Kingdom; Department of Obstetrics and Gynaecology (M.P.P.G.), Rotunda Hospital, Dublin 1, Ireland; and Program in Development and Fetal Health (J.C.P.K.), Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto M5G 1X5, Canada

Address all correspondence and requests for reprints to: Dr. P. C. Hindmarsh, Centre for Human Growth and Maturation, Cobbold Laboratories, Middlesex Hospital, Mortimer Street, London W1T 3AA, United Kingdom. E-mail: p.hindmarsh{at}ucl.ac.uk.

Background: Maternal smoking during pregnancy is associated with a reduction in birth size. Very few studies have collated changes in fetal biometry, neonatal anthropometry, biochemical factors involved in fetal growth, and measures of uterine and umbilical blood flow.

Methods: We related smoking status in 1650 low-risk, singleton Caucasian pregnancies delivering at term to measures of fetal growth, uterine and umbilical artery blood flow, placental appearance, birth size, and cord concentrations of IGF-I and -II and IGF binding protein (IGFBP)-3.

Results: Mothers who smoked in pregnancy were younger (P < 0.001) and shorter (P = 0.03) and from lower socioeconomic groups (P < 0.001). Mean umbilical artery blood flow at 20 wk gestation was not associated with smoking status but was significantly higher in smokers at 30 wk (P = 0.006). Uterine artery blood flow was unaffected. Smoking was associated with an increase in the percentage of abnormal placentas in a dose-dependent manner and with a 3.1-fold increased risk (odds ratio 3.1, 95% confidence interval 1.3–7.6) of abnormal umbilical artery blood flow (P = 0.009). Smoking was associated with a reduction in fetal femur length (P = 0.005) and abdominal circumference as well as birth weight, length, and head circumference but not skinfold thickness. Cord plasma concentrations of IGF-I and IGFBP-3 were lower in the babies of mothers who had smoked (P = 0.02 and P = 0.01, respectively).

Conclusion: We concluded that maternal smoking is associated with an altered placental appearance on ultrasonography, increased umbilical artery blood flow resistance, and a reduction in longitudinal and intraabdominal organ growth. Circulating concentrations of IGF-I and IGFBP-3 along with measures of birth size but not markers of body fat are reduced, suggesting smoking results in a reduction in organ size and function.

This article has been cited by other articles:

				C. Chiesa, J. F. Osborn, C. Haass, F. Natale, M. Spinelli, E. Scapillati, A. Spinelli, and L. Pacifico Ghrelin, Leptin, IGF-1, IGFBP-3, and Insulin Concentrations at Birth: Is There a Relationship with Fetal Growth and Neonatal Anthropometry? Clin. Chem., March 1, 2008; 54(3): 550 - 558. [Abstract] [Full Text] [PDF]

				C. C. Geerts, D. E. Grobbee, C. K. van der Ent, B. M. de Jong, M. M. van der Zalm, N. van Putte-Katier, J. L.L. Kimpen, and C. S.P.M. Uiterwaal Tobacco Smoke Exposure of Pregnant Mothers and Blood Pressure in Their Newborns: Results from the Wheezing Illnesses Study Leidsche Rijn Birth Cohort Hypertension, September 1, 2007; 50(3): 572 - 578. [Abstract] [Full Text] [PDF]

				P. Saenger, P. Czernichow, I. Hughes, and E. O. Reiter Small for Gestational Age: Short Stature and Beyond Endocr. Rev., April 1, 2007; 28(2): 219 - 251. [Abstract] [Full Text] [PDF]