This Article Full Text Full Text (PDF) All Versions of this Article: 119/6/857    most recent CIRCULATIONAHA.107.755769v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Andersen, M. R. Articles by Stender, S. Search for Related Content PubMed PubMed Citation Articles by Andersen, M. R. Articles by Stender, S. Pubmed/NCBI databases Medline Plus Health Information Quitting Smoking Related Collections Lipids Risk Factors Endothelium/vascular type/nitric oxide Related Article

(Circulation. 2009;119:857-864.)
© 2009 American Heart Association, Inc.

Pediatric Cardiology

Smoking Cessation Early in Pregnancy and Birth Weight, Length, Head Circumference, and Endothelial Nitric Oxide Synthase Activity in Umbilical and Chorionic Vessels

An Observational Study of Healthy Singleton Pregnancies

Malene R. Andersen, MSc, PhD; Ulf Simonsen, MD, PhD; Niels Uldbjerg, MD, PhD; Christian Aalkjær, MD, PhD; Steen Stender, MD, PhD

From the Department of Clinical Biochemistry, Gentofte University Hospital, Hellerup (M.R.A., S.S.); Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby (M.R.A., N.U.); and Institutes of Pharmacology (U.S.) and Physiology and Biophysics (C.A.), Aarhus University, Aarhus, Denmark.

Correspondence to Malene R. Andersen, Department of Clinical Biochemistry, Gentofte University Hospital, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark. E-mail mardan01{at}geh.regionh.dk

Received November 26, 2007; accepted November 24, 2008.

Background— Reduced production of the vasodilator nitric oxide (NO) in fetal vessels in pregnant smokers may lower the blood flow to the fetus and result in lower birth weight, length, and head circumference. The present study measured endothelial NO synthase (eNOS) activity in fetal umbilical and chorionic vessels from nonsmokers, smokers, and ex-smokers and related the findings to the fetal outcome.

Methods and Results— Of 266 healthy, singleton pregnancies, 182 women were nonsmokers, 43 were smokers, and 41 stopped smoking early in pregnancy. eNOS activity and concentration were quantified in endothelial cells of the fetal vessels. Cotinine, lipid profiles, estradiol, L-arginine, and dimethylarginines that may affect NO production were determined in maternal and fetal blood. Serum cotinine verified self-reported smoking. Newborns of smokers had a lower weight (P0.001) and a smaller head circumference (P0.041) and were shorter (P0.001) than newborns of nonsmokers and ex-smokers. eNOS activity in umbilical veins of smokers was 36% lower (P<0.001), eNOS concentration was 47% lower (P<0.001), and the fetal plasma level of high-density lipoprotein was 18% lower (P<0.001) than those of nonsmokers, whereas the same levels were found in umbilical veins from ex-smokers and nonsmokers. The same patterns in eNOS activity and concentration were found in umbilical arteries and chorionic vessels. Fetal plasma levels of estradiol, L-arginine, dimethylarginines, total cholesterol, and triglycerides were similar for nonsmokers, smokers, and ex-smokers.

Conclusions— The findings suggest that maternal smoking reduces eNOS activity in the fetal vascular bed, contributing to retarded fetal growth caused by the reduction of vasodilatory capacity, and suggest that smoking cessation early in pregnancy prevents these effects in newborns.

---

 

CLINICAL PERSPECTIVE

Related Article:

Clinical Summaries
Circulation 2009 119: 765-767. [Extract] [Full Text]