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Smoking: The Truth About Risk

By Julia Cruz
Beth Israel Deaconess Medical Center correspondent

When Dr. Karen O'Brien, a high-risk pregnancy specialist at Beth Israel Deaconess Medical Center, meets with a new mom-to-be or a woman who is trying to conceive, one of the first questions she asks is if the woman is smoking or lives with a smoker.

"It's a really important thing to address in prenatal care and preconception counseling because it's the most important modifiable risk factor associated with adverse pregnancy outcomes," says O'Brien.

The dangers of smoking are nothing new. It is well known that cigarettes contain harmful toxins - carcinogens like ammonia, carbon monoxide and heavy metals are just a few of the dozens of potentially poisonous additives found in cigarettes - and none of them are healthy for you or your unborn baby.

The list of potential problems from exposure to tobacco smoke is a long one - infertility, pre-term labor and delivery, low birth weight, placental eruption and dysplasia, ectopic pregnancy and miscarriage, just to name a few. Smoking or exposure to secondhand smoke is associated with 5 percent of infant deaths, 10 percent of pre-term births and 30 percent of underweight babies.

"It's most optimal if a pregnant mom stops smoking in the first trimester," stresses O'Brien. "But even if she cuts back as the pregnancy progresses, that's helpful."

Even if you're not a smoker, just being around a smoker can be dangerous for your unborn child. A recent study in the journal Pediatrics found exposure to secondhand smoke increased a non-smoking pregnant woman's chances of having a stillborn by 23 percent and increased the potential for delivering a baby with birth defects by 13 percent.

"We know that secondhand smoke exposure can lead to asthma, painful middle ear infections and Sudden Infant Death Syndrome (SIDS) in newborns," notes Dr. O'Brien. "Expectant mothers need to be really conscientious and vocal about noticing who is smoking around them. Ask the smoker to stop and remove that environmental hazard as fast as they can."

The risks don't stop at secondhand smoke, either. Now there is a new danger from thirdhand smoke - residue from nicotine that clings to hair, clothing, curtains, walls, bedding and furniture long after the smoking has stopped. Infants, children and pregnant women may be at risk just by touching, inhaling or ingesting substances that contain thirdhand smoke.

"It's a relatively new area that needs more exploration, but it's concerning as well," says Dr. O'Brien.

So don't be shy - tell the smokers around you to light up somewhere else. Make your home a smoke-free environment. And if you're smoking and pregnant or trying to become pregnant, now is the time to quit. Talk with your Ob-Gyn and join a smoking cessation support group.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2012

Contact Information

Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
East Campus
330 Brookline Avenue
Boston, MA 02215