The Impact of Maternal Smoking on Perinatal Complications in Iraq

Authors

  • Alaa Kamel Khalaf M.B.Ch.B., F.I.C.O.G., Obstetrician and Gynecologist, Iraqi Ministry of Health, Al-Rusafa Health Department, Kamal Al-Samerae Hospital, Baghdad, Iraq
  • Alaa Abdulateef Mohammed Salman M.B.Ch.B., D.G.O., C.A.B.O.G., F.I.R.M., Obstetrician and Gynecologist, Iraqi Ministry of Health, Al-Karkh Health Department, Al-Khadymia Teaching Hospital, Baghdad, Iraq
  • Nisreen Ali Hussein M.B.Ch.B., C.A.B.O.G., Obstetrician and Gynecologist, Iraqi Ministry of Health, Al-Karkh Health Department, Al-Khadymia Teaching Hospital, Baghdad, Iraq

DOI:

https://doi.org/10.51699/ijhsms.v3i3.84

Keywords:

Smoking, Pregnancy, Perinatal Complications, Delivery Outcome, Birthweight

Abstract

Smoking is negatively associated with birth outcomes for Iraqi pregnant women, with the fetus being at risk of stillbirth, neonatal death, and severe complications. The present study aims to investigate and enrol the clinical outcomes of perinatal complications among Iraqi smokers who are pregnant. A total of 63 pregnant Iraqi women, aged between 25 and 45 years, who had given birth in maternity hospitals in Baghdad, Iraq, were recruited between March 2023 and April 2024. The study enrolled the women's intrapartum outcomes, their daily cigarette use, and the dose of cigarettes they consumed during pregnancy. The clinical data pertaining to both the women and the fetuses were determined in terms of complications, pain, obstetric outcomes, and quality of life assessment. The study revealed that women in the 25–30 age group were the most prevalent participants, with 24 cases. The daily cigarette consumption was classified into four categories: <10 cigarettes per day (29 cases), ≥ 10 cigarettes per day (20 cases), and ≥20 cigarettes per day (14 cases). A total of 14 cases were identified, with gestational age in ≥ 37 weeks representing 53.97% of the total patient population. The mode of delivery was predominantly caesarean section (28.57%), while the remaining 71.43% underwent vaginal delivery. Low birth weight was identified as a risk factor. Of the total number of cases, ten were identified as having perinatal complications, representing a rate of 41.27% among all patients. Additionally, 22 cases were classified as having a birth weight of less than 2500 g. There were four instances of stillbirth. Pregnancy outcomes perinatal ones are adversely affected by cigarette smoking based on the dosages.

References

A. Hackshaw, C. Rodeck, and S. Boniface, "Maternal Smoking in Pregnancy and Birth Defects: A Systematic Review Based on 173,687 Malformed Cases and 11.7 Million Controls," Hum. Reprod. Update, vol. 17, no. 5, pp. 589-604, Sep.-Oct. 2011. DOI: https://doi.org/10.1093/humupd/dmr022

H. Ohmi, K. Hirooka, and Y. Mochizuki, "Fetal Growth and the Timing of Exposure to Maternal Smoking," Pediatr. Int., vol. 44, no. 1, pp. 55-59, 2002. DOI: https://doi.org/10.1046/j.1442-200X.2002.01495.x

K. Wisborg, T. B. Henriksen, M. Hedegaard, and N. J. Secher, "Smoking During Pregnancy and Preterm Birth," Br. J. Obstet. Gynaecol., vol. 103, no. 8, pp. 800-805, 1996. DOI: https://doi.org/10.1111/j.1471-0528.1996.tb09877.x

J. M. Lang, E. Lieberman, and A. Cohen, "A Comparison of Risk Factors for Preterm Labor and Term Small-for-Gestational-Age Birth," Epidemiology, vol. 7, no. 4, pp. 369-376, 1996. DOI: https://doi.org/10.1097/00001648-199607000-00006

R. L. Andres and M. C. Day, "Perinatal Complications Associated with Maternal Tobacco Use," Semin. Neonatol., vol. 5, no. 3, pp. 231-241, 2000. DOI: https://doi.org/10.1053/siny.2000.0025

D. Cuk, O. Mamula, and A. Frkovic, "The Effect of Maternal Smoking on Pregnancy Outcome," Lijec Vjesn., vol. 122, no. 5-6, pp. 103-110, 2000.

R. H. Secker-Walker and P. M. Vacek, "Relationships Between Cigarette Smoking During Pregnancy, Gestational Age, Maternal Weight Gain, and Infant Birth Weight," Addict. Behav., vol. 28, no. 1, pp. 55-66, 2003. DOI: https://doi.org/10.1016/S0306-4603(01)00216-7

S. J. Ventura, B. E. Hamilton, T. J. Mathews, and A. Chandra, "Trends and Variations in Smoking During Pregnancy and Low Birth Weight: Evidence from the Birth Certificate, 1990-2000," Pediatrics, vol. 111, no. 5 Pt 2, pp. 1176-1180, 2003. DOI: https://doi.org/10.1542/peds.111.S1.1176

K. K. Ong, M. A. Preece, P. M. Emmett, M. L. Ahmed, and D. B. Dunger, "Size at Birth and Early Childhood Growth in Relation to Maternal Smoking, Parity, and Infant Breastfeeding: Longitudinal Birth Cohort Study and Analysis," Pediatr. Res., vol. 52, no. 6, pp. 863-867, 2002. DOI: https://doi.org/10.1203/00006450-200212000-00009

M. C. Kataoka, A. P. P. Carvalheira, A. P. Ferrari, et al., "Smoking During Pregnancy and Harm Reduction in Birth Weight: A Cross-Sectional Study," BMC Pregnancy Childbirth, vol. 18, p. 67, 2018. DOI: https://doi.org/10.1186/s12884-018-1694-4

J. M. Sequí-Canet, J. M. Sequí-Sabater, A. Marco-Sabater, F. Corpas-Burgos, J. I. Collar Del Castillo, and N. Orta-Sibú, "Maternal Factors Associated with Smoking During Gestation and Consequences in Newborns: Results of an 18-Year Study," J. Clin. Transl. Res., vol. 8, no. 1, pp. 6-19, Jan. 2022.

R. Claire, C. Chamberlain, M. A. Davey, S. E. Cooper, I. Berlin, J. Leonardi-Bee, and T. Coleman, "Pharmacological Interventions for Promoting Smoking Cessation During Pregnancy," Cochrane Database Syst. Rev., vol. 3, p. CD010078, Mar. 2020. DOI: https://doi.org/10.1002/14651858.CD010078.pub3

B. Tarasi, J. Cornuz, C. Clair, and D. Baud, "Cigarette Smoking During Pregnancy and Adverse Perinatal Outcomes: A Cross-Sectional Study Over Ten Years," BMC Public Health, vol. 22, p. 2403, Dec. 2022. DOI: https://doi.org/10.1186/s12889-022-14881-4

H. He, Z. Pan, J. Wu, C. Hu, L. Bai, and J. Lyu, "Health Effects of Tobacco at the Global, Regional, and National Levels: Results from the 2019 Global Burden of Disease Study," Nicotine Tob. Res., vol. 24, no. 6, pp. 864-870, Apr. 2022. DOI: https://doi.org/10.1093/ntr/ntab265

M. Cheraghi and S. Salvi, "Environmental Tobacco Smoke (ETS) and Respiratory Health in Children," Eur. J. Pediatr., vol. 168, pp. 897-905, 2009. DOI: https://doi.org/10.1007/s00431-009-0967-3

H. Burke, J. Leonardi-Bee, A. Hashim, H. Pine-Abata, Y. Chen, D. G. Cook, et al., "Prenatal and Passive Smoke Exposure and Incidence of Asthma and Wheeze: Systematic Review and Meta-Analysis," Pediatrics, vol. 129, pp. 735-744, 2012. DOI: https://doi.org/10.1542/peds.2011-2196

R. Lawder, B. Whyte, R. Wood, C. Fischbacher, and D. M. Tappin, "Impact of Maternal Smoking on Early Childhood Health: A Retrospective Cohort-Linked Dataset Analysis of 697,003 Children Born in Scotland 1997-2009," BMJ Open, vol. 9, no. 3, p. e023213, Mar. 2019. DOI: https://doi.org/10.1136/bmjopen-2018-023213

R. Li, J. Lodge, C. Flatley, and S. Kumar, "The Burden of Adverse Obstetric and Perinatal Outcomes from Maternal Smoking in an Australian Cohort," Aust. N. Z. J. Obstet. Gynaecol., vol. 59, no. 3, pp. 356-361, 2019.

B. Liu, G. Xu, Y. Sun, et al., "Maternal Cigarette Smoking Before and During Pregnancy and the Risk of Preterm Birth: A Dose-Response Analysis of 25 Million Mother-Infant Pairs," PLoS Med., vol. 17, no. 8, p. e1003158, 2020. DOI: https://doi.org/10.1371/journal.pmed.1003158

P. C. Lisboa, E. de Oliveira, and E. G. de Moura, "Obesity and Endocrine Dysfunction Programmed by Maternal Smoking in Pregnancy and Lactation," Front. Physiol., vol. 3, p. 437, 2012. DOI: https://doi.org/10.3389/fphys.2012.00437

J. E. Bruin, H. C. Gerstein, and A. C. Holloway, "Long-Term Consequences of Fetal and Neonatal Nicotine Exposure: A Critical Review," Toxicol. Sci., vol. 116, pp. 364-374, 2010. DOI: https://doi.org/10.1093/toxsci/kfq103

S. Schneider, C. Huy, J. Schütz, and K. Diehl, "Smoking Cessation During Pregnancy: A Systematic Literature Review," Drug Alcohol Rev., vol. 29, pp. 81-90, 2010. DOI: https://doi.org/10.1111/j.1465-3362.2009.00098.x

M. Cudmore, S. Ahmad, B. Al-Ani, T. Fujisawa, H. Coxall, K. Chudasama, L. R. Devey, S. J. Wigmore, A. Abbas, P. W. Hewett, and A. Ahmed, "Negative Regulation of Soluble Flt-1 and Soluble Endoglin Release by Heme Oxygenase-1," Circulation, vol. 115, pp. 1789-1797, 2007. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.660134

R. J. Levine, S. E. Maynard, C. Qian, K. H. Lim, L. J. England, K. F. Yu, E. F. Schisterman, R. Thadhani, B. P. Sachs, F. H. Epstein, B. M. Sibai, V. P. Sukhatme, and S. A. Karumanchi, "Circulating Angiogenic Factors and the Risk of Preeclampsia," N. Engl. J. Med., vol. 350, pp. 672-683, 2004. DOI: https://doi.org/10.1056/NEJMoa031884

R. J. Levine, C. Lam, C. Qian, K. F. Yu, S. E. Maynard, B. P. Sachs, B. M. Sibai, F. H. Epstein, R. Romero, R. Thadhani, and S. A. Karumanchi, "Soluble Endoglin and Other Circulating Antiangiogenic Factors in Preeclampsia," N. Engl. J. Med., vol. 355, pp. 992-1005, 2006. DOI: https://doi.org/10.1056/NEJMoa055352

B. Kelkay, A. Omer, Y. Teferi, and Y. Moges, "Factors Associated with Singleton Preterm Birth in Shire Suhul General Hospital, Northern Ethiopia, 2018," J. Pregnancy, vol. 2019, p. 4629101, 2019. DOI: https://doi.org/10.1155/2019/4629101

T. S. Avşar, H. McLeod, and L. Jackson, "Health Outcomes of Smoking During Pregnancy and the Postpartum Period: An Umbrella Review," BMC Pregnancy Childbirth, vol. 21, p. 254, 2021. DOI: https://doi.org/10.1186/s12884-021-03729-1

A. W. G. Ratnasiri, L. Gordon, R. A. Dieckmann, H. C. Lee, S. S. Parry, V. N. Arief, et al., "Smoking During Pregnancy and Adverse Birth and Maternal Outcomes in California, 2007 to 2016," Am. J. Perinatol., vol. 37, no. 13, pp. 1364-1376, 2020. DOI: https://doi.org/10.1055/s-0039-1693689

R. Li, J. Lodge, C. Flatley, and S. Kumar, "The Burden of Adverse Obstetric and Perinatal Outcomes from Maternal Smoking in an Australian Cohort," Aust. N. Z. J. Obstet. Gynaecol., vol. 59, no. 3, pp. 356-361, 2019. DOI: https://doi.org/10.1111/ajo.12849

D. Baud, S. Meyer, Y. Vial, P. Hohlfeld, and C. Achtari, "Pelvic Floor Dysfunction Six Years Post-Anal Sphincter Tear at the Time of Vaginal Delivery," Int. Urogynecol. J., vol. 22, no. 9, pp. 1127-1134, 2011. DOI: https://doi.org/10.1007/s00192-011-1431-2

D. M. Morales-Prieto, P. Fuentes-Zacarías, J. M. Murrieta-Coxca, R. N. Gutierrez-Samudio, R. R. Favaro, J. S. Fitzgerald, et al., "Smoking for Two-Effects of Tobacco Consumption on the Placenta," Mol. Aspects Med., vol. 87, p. 101023, 2021. DOI: https://doi.org/10.1016/j.mam.2021.101023

C. Jiang, Q. Chen, and M. Xie, "Smoking Increases the Risk of Infectious Diseases: A Narrative Review," Tob. Induc. Dis., vol. 18, p. 60, 2020. DOI: https://doi.org/10.18332/tid/123845

J. Bagaitkar, D. R. Demuth, and D. A. Scott, "Tobacco Use Increases Susceptibility to Bacterial Infection," Tob. Induc. Dis., vol. 4, p. 12, 2008. DOI: https://doi.org/10.1186/1617-9625-4-12

S. A. Karumanchi and R. J. Levine, "How Does Smoking Reduce the Risk of Preeclampsia?" Hypertension, vol. 55, no. 5, pp. 1100-1101, 2010. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.109.148973

M. A. Luque-Fernandez, H. Zoega, U. Valdimarsdottir, and M. A. Williams, "Deconstructing the Smoking-Preeclampsia Paradox Through a Counterfactual Framework," Eur. J. Epidemiol., vol. 31, no. 6, pp. 613-623, 2016. DOI: https://doi.org/10.1007/s10654-016-0139-5

M. Zaigham, S. Helfer, K. H. Kristensen, P. E. Isberg, and N. Wiberg, "Maternal Arterial Blood Gas Values During Delivery: Effect of Mode of Delivery, Maternal Characteristics, Obstetric Interventions and Correlation to Fetal Umbilical Cord Blood," Acta Obstet. Gynecol. Scand., vol. 99, no. 12, pp. 1674-1681, 2020. DOI: https://doi.org/10.1111/aogs.13936

A. Diamanti, S. Papadakis, S. Schoretsaniti, N. Rovina, V. Vivilaki, C. Gratziou, et al., "Smoking Cessation in Pregnancy: An Update for Maternity Care Practitioners," Tob. Induc. Dis., vol. 17, p. 57, 2019. DOI: https://doi.org/10.18332/tid/109906

L. W. S. Leung and G. A. Davies, "Smoking Cessation Strategies in Pregnancy," J. Obstet. Gynaecol. Can., vol. 37, no. 9, pp. 791-797, 2015. DOI: https://doi.org/10.1016/S1701-2163(15)30149-3

J. M. G. Crane, M. Keough, P. Murphy, L. Burrage, and D. Hutchens, "Effects of Environmental Tobacco Smoke on Perinatal Outcomes: A Retrospective Cohort Study," BJOG, vol. 118, no. 7, pp. 865-871, 2011. DOI: https://doi.org/10.1111/j.1471-0528.2011.02941.x

S. Popova, D. Dozet, G. O’Hanlon, V. Temple, and J. Rehm, "Maternal Alcohol Use, Adverse Neonatal Outcomes and Pregnancy Complications in British Columbia, Canada: A Population-Based Study," BMC Pregnancy Childbirth, vol. 21, p. 74, 2021. DOI: https://doi.org/10.1186/s12884-021-03545-7

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Published

2024-09-04

How to Cite

Khalaf, A. K., Salman, A. A. M., & Hussein, N. A. (2024). The Impact of Maternal Smoking on Perinatal Complications in Iraq. International Journal of Health Systems and Medical Sciences, 3(3), 303–313. https://doi.org/10.51699/ijhsms.v3i3.84

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