The effect of cigarette or sheesha smoking on first-trimester markers of Down syndrome

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OBJECTIVE: To investigate the influence of cigarette or sheesha smoking on first-trimester markers of Down syndrome. DESIGN: A prospective observational study. SETTING: Primary care centres and antenatal clinics of Maternity and Children Hospital, King Abdulaziz University Hospital and New Jeddah Clinic Hospital, Jeddah, Saudi Arabia. POPULATION: Women with a singleton pregnancy who were either nonsmokers (n = 1736) or cigarette smokers (n = 420) or sheesha smokers (n = 181). METHODS: Fetal nuchal translucency thickness (fetal NT), maternal serum free beta-human chorionic gonadotrophin (free beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) were measured at 11 weeks 0 days to 13 weeks 6 days of gestation in all women. Women were grouped according to smoking status, confirmed by maternal serum cotinine measurements, and analyte levels between groups were compared. MAIN OUTCOME MEASURES: Fetal NT, maternal serum free beta-hCG, PAPP-A and cotinine measurements. RESULTS: Compared with nonsmoking women, fetal NT was significantly increased and free beta-hCG and PAPP-A levels were significantly decreased in both cigarette and sheesha smokers. There were significant relationships between all three markers and the number of sheeshas consumed per day. CONCLUSIONS: Cigarette and sheesha smoking significantly affect first-trimester markers of Down syndrome (fetal NT, free beta-hCG and PAPP-A). Correction for this effect in women who smoke might improve the effectiveness of first-trimester screening for Down syndrome in these women. The underlying mechanism(s) relating smoking to the changes in first-trimester markers require further studies.

Down Syndrome/etiology, Smoking/adverse effects, Adult, Biological Markers/metabolism, Birth Weight, Chorionic Gonadotropin/metabolism, Cotinine/metabolism, Crown-Rump Length, Down Syndrome/diagnosis, Female, Humans, Male, Pregnancy, Pregnancy Outcome, Pregnancy-Associated Plasma Protein-A/metabolism, Prospective Studies, Saudi Arabia, Sex Distribution, Smoking/blood

http://pesquisa.bvsalud.org/ghl/resource/en/mdl-17803717

MEDLINE; http://www.globalhealthlibrary.net/

Ardawi,M. S. M., Nasrat,H. A., Rouzi,A. A., Qari,M. H., Al-Qahtani,M., Abuzenadah,A. M.

http://vp9py7xf3h.search.serialssolutions.com/?charset=utf-8&pmid=

2007