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Am J Perinatol 2005; 22(1): 41-47
DOI: 10.1055/s-2004-837266
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Prenatal Tobacco Smoke Exposure, as Measured by Midgestation Serum Cotinine Levels, on Fetal Biometry and Umbilical Flow Velocity Waveforms

Jarosław Kalinka1 , Wojciech Hanke2 , Wojciech Sobala2
  • 1Department of Perinatology, Institute of Gynecology and Obstetrics, Medical University of Lodz, Poland
  • 2Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
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Publication Date:
11 January 2005 (online)

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ABSTRACT

The aim of this prospective cohort study was to evaluate the impact of tobacco smoke exposure, measured by maternal serum concentration of cotinine, on fetal midgestation biometric parameters and umbilical artery (UA) qualitative blood flow indices. The study population consisted of 114 healthy women in 20 to 24 weeks gestation who were recruited from the patients of two antenatal care units in Lodz, Poland. Significant negative correlation was found between fetal biparietal diameter (BPD) and serum cotinine concentration. Serum cotinine positively correlated with all blood flow indices under study (systolic/diastolic index [S/D], resistance index, and pulsatility index) after controlling for gestational age, gender, and femur length. The midgestation UA S/D ratio > 3 was found to be a significant risk factor for decreased birthweight. Tobacco smoke exposure is a significant factor inducing increased resistance of umbilical blood flow as measured in 20 to 24 weeks gestation. This could be one of the main mechanisms leading to decreased birthweight observed among infants with prenatal exposure to tobacco smoke.

KEYWORDS

Environmental tobacco smoke exposure - cotinine - uteroplacental circulation

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Jarosław KalinkaM.D. Ph.D. 

Department of Perinatology, Institute of Gynecology and Obstetrics, Medical University of Lodz

ul. Wilenska 37, 94-029 Lodz, Poland