原创力文档quantitative effects of tobacco smoking exposure on the maternal-fetal circulation定量的影响吸烟暴露在母胎循环.pdfVIP
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quantitative effects of tobacco smoking exposure on the maternal-fetal circulation定量的影响吸烟暴露在母胎循环
de B Machado et al. BMC Pregnancy and Childbirth 2011, 11:24
/1471-2393/11/24
RESEARCH ARTICLE Open Access
Quantitative effects of tobacco smoking exposure
on the maternal-fetal circulation
Julia de B Machado1*†, Plínio VM Filho1†, Guilherme O Petersen2† and José M Chatkin3†
Abstract
Background: Despite the existence of various published studies regarding the effects of tobacco smoking on
pregnancy, and especially in regards to placental blood flow and vascular resistance, some points still require
clarification. In addition, the amount of damage due to tobacco smoking exposure that occurs has not been
quantified by objective means. In this study, we looked for a possible association between flow resistance indices
of several arteries and the levels of urinary cotinine and the concentration of carbon monoxide in the exhaled air
(COex) of both smoking and non-smoking pregnant women. We also looked for a relationship between those
findings and fetal growth and birth weight.
Methods: In a prospective design, thirty pregnant smokers and thirty-four pregnant non-smokers were studied.
The volunteers signed consent forms, completed a self-applied questionnaire and were subjected to Doppler
velocimetry. Tobacco smoking exposure was quantified by subject provided information and confirmed by the
measurement of urinary cotinine levels and by the concentration of carbon monoxide in the exhaled air (COex).
The weight of newborns was evaluated immediately after birth.
Results: Comparing smoking to non-smoking pregnant women, a significant increase in the resistance index was
observed in the uterine arteries (P = 0.001) and umbilical artery (P = 0.001), and a decrease in the middle cerebral
artery (P = 0.450). These findings were associated with progressively higher concentrations of COex and urinary
cotinine. A decrease i
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