General Chat

Missing or deformed limbs, clubfoot, facial disorders and gastrointestinal problems are some of the most common birth defects found to be associated with smoking during pregnancy, according to a major new report led by scientists at UCL. The study, published today in Human Reproduction Update, is the first comprehensive review to identify the specific birth defects (malformations) most associated with smoking.

Despite public health advice which warns of the harms of maternal smoking, such as miscarriage and premature birth, in the UK 45% of women under 20 and 17% overall still smoke during pregnancy, according to the national figures (Office for National Statistics 2006). In the USA, 20% of women aged under 25 years smoke during pregnancy, compared to 9% among those aged over 35.

The authors examined a total of 172 research papers published over the last 50 years, which looked at a combined total of 174,000 cases of malformation alongside 11.7 million controls. The risk was increased by 26% for having a baby with missing or deformed limbs, 28% for clubfoot, 27% for gastrointestinal defects, 33% for skull defects, 25% for eye defects, and 28% for cleft lip/palate. The greatest increase in risk (50%) was for a condition called gastroschisis, where parts of the stomach or intestines protrude through the skin.

The research authors recommend that public health guidance should now be more explicit about the specific malformations associated with maternal smoking, in order to try and reduce the numbers of pregnant women who smoke.

Lead author Professor Allan Hackshaw, UCL Cancer Institute and member of the Royal College of Physicians Tobacco Advisory Group, said: "People may think that few women still smoke when pregnant. But the reality is that, particularly in women under 20, the numbers are still staggeringly high.

"Maternal smoking during pregnancy is a well established risk factor for miscarriage, low birthweight and premature birth. However, very few public health educational policies mention birth defects when referring to smoking and those that do are not very specific – this is largely because of past uncertainty over which ones are directly linked.

"Now we have this evidence, advice should be more explicit about the kinds of serious defects such as deformed limbs, and facial and gastrointestinal malformations that babies of mothers who smoke during pregnancy could suffer from. The message from this research is that women should quit smoking before becoming pregnant, or very early on, to reduce the chance of having a baby with a serious and lifelong physical defect."

Co-author, Professor Charles Rodeck, UCL Institute for Women's Health, added: "The results of this research are of the greatest significance for the health of mothers and babies and for public health policy. If the recommendations are implemented, they will lead to a reduction in the incidence of several common malformations, and also to greater efficacy of smoking prevention programmes, as the warning of a birth defect adds weight to that of a small or premature baby".
Published: Monday, July 11, 2011 - 21:34 in Health & Medicine
Source: University College London

"A cigarette is a pinch of tobacco, wrapped in paper, fire at one end & a fool at the other".

This was my dad's favourite quotation having smoked 20 a day for most of his adult life. But, he was never pregnant - as far as I know.

To get a full report on the study please refer to:

http://www.nhs.uk/news/2011/07July/Pages/smoking-in-pregnancy-link-to-birth-defects.aspx

I appreciate that every baby born with a defect (small or significant) is a tragedy for the parents and extended family but why no mention of other factors?

Drink, drugs, poor nutrition etc.,

Sue

i tend to agree with sue on this one although smoking in pregnancy is aterrible thing.these days just walking outside and breathing in the fumes of passing cars must also put an unborn child at risk,(we cant do anything about that can we)also like sue said there is also the fact that expectant mothers also drink,take drugs and dont look after themselves(not all expectant mothers of course). my daughter has a 10m old daughter,she didnt smoke at all during pregnancy but her friend did,my granddaughter weighed 8lbs 4oz at birth(a good normal weight)my daughters friends baby born a month before weighed 10lbs 2oz and she had smoked 20 a day all the way through.x :-)

I smoked through both of my pregnancies in the 70s.
Maybe my kids were just lucky, but they are both healthy intelligent girls with good jobs & families of their own now.
I wouldn´t recommend that anyone starts smoking, but it´s effects seem to be as hit and miss as anything else. Friends have died of the same diseases & one has been a lifelong smoker & the other has never smoked.
I would agree that pollution & the other dangers associated with modern living have a big part to play.

Isn't the point though that this was a very specific look at previous research re smoking in pregnancy ? not meant as a general survey on all the other things that might cause defects?

"The researchers discussed some other potential limitations of their review that they tried to address, including:

•“Publication bias” could potentially have occured if studies that found little or no association between maternal smoking and birth defects were less likely to be published. However, the researchers performed some statistical tests to assess whether this had happened and found that there was none.

•An inherent problem with conducting a systematic review is that data from a wide variety of studies is pooled, which may have differences in their study designs. There are also many other factors that may affect the risk of birth defects, such as maternal age and alcohol use. The researchers pooled risk calculations from the included studies that had taken into account such potential confounding factors. However, the factors that were taken into account may have varied between the included studies.

However, overall, this was a well-conducted study, and its findings are convincing evidence that smoking does increase the risk of some birth defects."

Of course other things contribute...I expect there are other research details to be found on those. The fact that 'most' smokers who continue to do so during pregnancy DON'T have babies with defects isn't relevant.... any more than saying " Joe smoked 60 a day and lived to be 106" we all know people who do b***** daft things with no ill effects...and those who try not to, but end up dying young anyway.

It's just a good idea to have the knowledge and weigh up the risks surely?

Len, you forgot the Whisky and the Wild Wild Bit. :-D

Nice to see that Len is still posting........

I am of the opinion, that what ever drug the mother takes consistently,during pregnancy, causes the infant to be addicted.....and after birth,the child suffers drastic withdrawal trauma.

Bob

It disgusts me to see pregnant women smoking, they obviously do not care what effect it has on their unborn child. There has been enough publicity and there have recently been programmes on tv, showing young women who are still smoking when pregnant and boasting about it, even tho when they go along to a special clinic which shows them the effect it has on stopping the oxygen supply, some do try to give up. They also try to educate them to eat better when pregnant or stop drinking etc. Too many people just get pregnant without a care, when it's so much better to have a good diet and stop smoking before even trying for a baby. Fathers need to stop smoking and drinking etc before attempting to make a baby too, it's not just the women who have to take responsibility.
You would think they would want to do the best for their little one, they spend a fortune on fancy clothes, buggies etc etc but can't do the main thing which is be as healthy as possible before conception. A happy healthy baby won't care if it's in designer clothes but if it has asthma or a low birth weight, that's a different matter.

Lizx

Again i know this thread is just about smoking in preg,smoking in pregnancy is very common as is taking drugs,drinking and sleeping around and contracting S.D.Ts(apart from drugs ,S.D.Ts in pregnancy cause all sorts of problems mostly concerning the eyes)when you take into account the effect of drugs,drink,smoking ,bad diet and S.D.Ts on the unborn child,smoking and bad diet would come up very low on the scale.afterworking on a S.C.B.U(special care baby unit)at the local hos for two yrs ,most of the prem babys were born to mothers who were on drugs or drank through preg,or to woman who hadreally lookedafter themselves during preg.you can give birth to a low birth weight baby for many reasons. :-D

Merlin - no I didn't. I was keeping them to myself.

Unfortunately 'researchers' need to earn a living and will grab onto any current issue to maintain their income.
I didn't smoke during either of my regnancies but drank a bottle of Mackeson every day as the doctor recommended it!
Both my children were okay despite my being given Debendox a thalidomoid based drug during my first pregnancy!
I've known pregnancies of women since that have resulted in problems like lack of amniotic fluid resulting in deformed feet and neither parent smoked.
A colleague at work who couldnt conceive etc
Statistics are what you make of them.

I remember a headilne in the 1980's where it stated that 25% of crime was committed by black youth.
It failed to point out that 75% werentt!!!

wellsaid maggie
after working for 2yrs on the special care baby unit,ive got to say that smoking in pregnancy comes very low on the scale of problems during pregnancy......but of course smoking as well as all the other thingsis very wrong,but dont think because you dont smoke during pregnancy you wont have problems..you will never be closer to death than during labour(except when you are dying) having a baby is a very dangerous thing, anything could go wrong.x ive seen more birth defects caused by problems during labour than enything else.xx