Article

Smoking and risk of preeclampsia: a systematic review.

Division of Reproductive Health, Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, GA, USA.
Frontiers in Bioscience (Impact Factor: 3.29). 02/2007; 12:2471-83. DOI: 10.2741/2248
Source: PubMed

ABSTRACT Cigarette smoking adversely affects every organ system. Paradoxically, smoking during pregnancy has been associated with a reduced risk of preeclampsia. We reviewed previous epidemiologic and clinical studies on the association between smoking and preeclampsia from 1959 to March, 2006. A total of 48 epidemiologic studies were identified. Overall, smoking during pregnancy reduces the risk of preeclampsia by up to 50% with a dose-response pattern. A protective effect was consistently found in both nulliparas and multiparas, singleton and multifetal pregnancies, and for mild and severe preeclampsia. Evidence on whether quitting smoking before or in early pregnancy reduces the risk remains inconclusive. To understand possible biologic mechanism(s) of the protective effect, we reviewed literature on potential pathophysiology of smoking and its effects on placenta, cardiovascular and immune systems. Although current literature does not lend clear evidence to support a particular mechanism for the protective effect of smoking, smoking might have effects on angiogenic factors, endothelial function and the immune system which act to lower risk of preeclampsia. More epidemiologic studies with biochemically confirmed smoking status and laboratory studies with a focus on promising pathways are warranted to further clarify this puzzling relationship. Understanding the underlying mechanisms through which smoking reduces preeclampsia risk may enhance our understanding of the pathogenesis of this disorder and contribute to the development of prevention strategies.

2 Bookmarks
 · 
206 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Preeclampsia (PE) remains a leading cause of maternal and neonatal morbidity and mortality worldwide. Smoking cigarettes is associated with a decreased incidence of PE. Based on this observation and previous work, we hypothesize that women who smoke have a lower risk of developing PE because of elevated levels of carbon monoxide (CO) in their blood. The objective of this study was to determine if low-dose CO in ambient air could attenuate the late pregnancy hypertension (HTN) and proteinuria in the Adenovirus (Ad) sFlt-1 PE-like mouse model. Continuous low-dose CO treatment (250 ppm) was started on E10.5 and maintained until E17.5. Compared to control and Ad empty vector, AdsFlt-1 mice displayed late- gestation HTN (E14.5-17.5) (P<0.05), proteinuria (P<0.05) and reduced Bowman's space which were all prevented with CO treatment. Use of the Ad (with/without sFlt-1) or CO had no effect (p>0.05) on litter size, fetal resorption numbers and fetal or placental weights. This study shows that treatment with CO can prevent HTN and proteinuria in a mouse model of PE. It provides a possible mechanism for the reduced incidence of PE in smoking women, and supports the possibility of using CO as a future treatment for PE.
    PLoS ONE 01/2014; 9(9):e106502. · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.
    PLoS ONE 01/2014; 9(10):e106446. · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Preeclampsia is a pregnancy-specific disorder that affects 2–8% of all pregnancies and remains a leading cause of maternal and perinatal morbidity and mortality worldwide. Diagnosis is based on new onset of hypertension and proteinuria. Multiple organ systems can be affected, with severe disease resulting. The wide range of risk factors reflects the heterogeneity of preeclampsia. Obesity, which is increasing at an alarming rate, is also a risk factor for preeclampsia as well as for later-life cardiovascular disease. Exploring common features may provide insight into the pathophysiologic mechanisms underlying preeclampsia among obese and overweight women.
    Nutrition Reviews 10/2013; 71(S1). · 4.60 Impact Factor

Full-text (2 Sources)

Download
40 Downloads
Available from
Jun 5, 2014