Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation 英文参考文献.docVIP

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Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation 英文参考文献.doc

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Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation 英文参考文献

deBMachadoetal.BMCPregnancyandChildbirth2011,11:24 /1471-2393/11/24 RESEARCH ARTICLE OpenAccess Quantitativeeffectsoftobaccosmokingexposure onthematernal-fetalcirculation JuliadeBMachado1*?,PlínioVMFilho1?,GuilhermeOPetersen2?andJoséMChatkin3? Abstract Background:Despitetheexistenceofvariouspublishedstudiesregardingtheeffectsoftobaccosmokingon pregnancy,andespeciallyinregardstoplacentalbloodflowandvascularresistance,somepointsstillrequire clarification.Inaddition,theamountofdamageduetotobaccosmokingexposurethatoccurshasnotbeen quantifiedbyobjectivemeans.Inthisstudy,welookedforapossibleassociationbetweenflowresistanceindices ofseveralarteriesandthelevelsofurinarycotinineandtheconcentrationofcarbonmonoxideintheexhaledair (COex)ofbothsmokingandnon-smokingpregnantwomen.Wealsolookedforarelationshipbetweenthose findingsandfetalgrowthandbirthweight. Methods:Inaprospectivedesign,thirtypregnantsmokersandthirty-fourpregnantnon-smokerswerestudied. Thevolunteerssignedconsentforms,completedaself-appliedquestionnaireandweresubjectedtoDoppler velocimetry.Tobaccosmokingexposurewasquantifiedbysubjectprovidedinformationandconfirmedbythe measurementofurinarycotininelevelsandbytheconcentrationofcarbonmonoxideintheexhaledair(COex). Theweightofnewbornswasevaluatedimmediatelyafterbirth. Results:Comparingsmokingtonon-smokingpregnantwomen,asignificantincreaseintheresistanceindexwas observedintheuterinearteries(P=0.001)andumbilicalartery(P=0.001),andadecreaseinthemiddlecerebral artery(P=0.450).ThesefindingswereassociatedwithprogressivelyhigherconcentrationsofCOexandurinary cotinine.Adecreaseinthebirthweightwasalsodetected(P0.001)inassociationwithaprogressiveincreasein thetobaccoexposureofthepregnantwoman. Conclusions:Inpregnantwomenwhosmoke,higherarterialresistanceindicesandlowerbirthweightswere observed,andthesefindingswereassociatedwithincreasinglevelsoftobaccosmokingexposure.Thevalueswere significantlydifferentwhencomparedtothosefoundinnon-smokingpregnantwomen.Thisstudycontributesto th