Document Detail

Maternal smoking during pregnancy, fetal arterial resistance adaptations and cardiovascular function in childhood.
MedLine Citation:
PMID:  21385303     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To unravel the mechanisms underlying the previously demonstrated associations between low birthweight and cardiovascular disease in adulthood, we examined whether maternal smoking during pregnancy leads to fetal arterial resistance adaptations, and subsequently to fetal growth retardation and changes in postnatal blood pressure and cardiac development.
DESIGN: Prospective cohort study from early fetal life onwards.
SETTING: Academic hospital.
POPULATION: Analyses were based on 1120 children aged 2 years.
METHODS: Maternal smoking during pregnancy [non-smoking, first trimester smoking, continued smoking (< 5 and ≥ 5 cigarettes/day)] was assessed by questionnaire.
MAIN OUTCOME MEASURES: Third trimester placental and fetal arterial resistance indices and fetal growth were assessed by ultrasound and Doppler measurements. Postnatal blood pressure and cardiac structures (aortic root diameter, left atrial diameter, left ventricular mass) were measured at 2 years of age.
RESULTS: First trimester smoking was not associated with third trimester placental and fetal blood flow adaptations. Continued smoking of ≥ 5 cigarettes/day was associated with an increased resistance in uterine, umbilical and middle cerebral arteries, and with a decreased flow and diameter of the ascending aorta. Among mothers who continued to smoke, the third trimester estimated fetal weights and birthweights were most affected in children with the highest umbilical artery resistance. Fetal arterial resistance indices were also associated with aortic root diameter and left atrial diameter.
CONCLUSIONS: Fetal arterial resistance adaptations may be involved in the pathways leading from maternal smoking during pregnancy to low birthweight and cardiovascular developmental changes in childhood in the offspring.
J J M Geelhoed; H El Marroun; B O Verburg; L van Osch-Gevers; A Hofman; A C Huizink; H A Moll; F C Verhulst; W A Helbing; E A P Steegers; V W V Jaddoe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-03-08
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  118     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-12     Completed Date:  2011-09-13     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  755-62     Citation Subset:  AIM; IM    
Copyright Information:
© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.
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MeSH Terms
Adaptation, Physiological / physiology
Blood Flow Velocity
Blood Pressure / physiology
Cardiovascular Diseases / congenital*
Cohort Studies
Fetal Growth Retardation / etiology*,  physiopathology
Fetal Heart / embryology
Fetus / blood supply*
Heart Ventricles / embryology
Middle Cerebral Artery
Pregnancy Trimester, Third
Prenatal Exposure Delayed Effects
Vascular Resistance / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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