Women's Safety Information

There is strong evidence that pregnant women who smoke cigarettes are thereby increasing the risk of death of their babies, a Public Health Service report said. The report contains the strongest statement on the risks of smoking in pregnancy ever made by the Public Health Service. “Numerous retrospective and prospective studies have revealed a statistically significant relationship between cigarette smoking and an elevated mortality risk among the infants of smokers,” says the report.

The document also raised doubts concerning the safety of the little cigars that have become increasingly popular. Many people can inhale these much as they do cigarettes, the Public Health Service reported, and those who do will probably face increased risks of the lung and heart problems that have been linked to cigarette smoking. Smokers of pipes and large cigars were told they face some health risks too, but the report made its strongest attack against cigarettes and was particularly strong concerning the risks in pregnancy.

It said several lines of evidence were accumulating to show “a strong, probably casual association between cigarette smoking and higher late fetal and infant mortality among smokers’ infants.” Basically, that means still-births and deaths during the first few days of life.

The report said that several thousand stillbirths a year in the United States can probably be accounted for by the smoking habits of the women involved. The pediatrician who wrote that section of the report noted that the number was roughly equal to two-thirds of all the deaths from accidents in Americans aged one to 14. Accidents are the leading cause of death in that age group.

Among the several hundred references cited in the Public Health Service document was a British report showing that smoking mothers had a stillbirth rate 30 per cent higher than nonsmokers and an infant death rate for the first few days after birth 26 percent higher than mothers who do not use cigarettes. The report also said new data suggests that the woman who gives up smoking by the fourth month of her pregnancy eliminates the heightened risk for her unborn baby.

It has been known for a while that women who smoke cigarettes bear children with a lower average birth-weight than babies of nonsmokers. The Public Health Service document said every investigator who had examined this relationship had confirmed it. Some studies have also found a higher mortality rate among infants of smoking mothers, while others have not. Thus there has been controversy and confusion over the significance of the findings. This report puts firth what it feels is a probably explanation of much of the past discrepancies. For example, the report said the small babies of smoking women appeared to be small for their age, but not premature in calendar and developmental sense. Prematurity – meaning birth before full development – involves a strong risk. Therefore, the report argues, a premature baby of a nonsmoking mother may sometimes be at greater risk than a small, but mature baby of a smoking mother, but this does not invalidate the case against smoking.

Furthermore, in the United States, the statistics show that women of lower socio-economic status and women who have a previous history of unsuccessful pregnancy have greater than average risks of stillbirth or early infant deaths. Although cigarette smoking exerts an independent influence of its own, this can be hidden or influenced by the other factors, the report said. Thus these other factors must be taken into account in seeking clear evidence for the effect of cigarette smoking by itself.

The report said that three major studies have now done this and show a “highly significant independent association between smoking and mortality.”

Of the questions of spontaneous abortion and birth defects, the report said there was not enough evidence to allow any firm conclusions. This document also cited animal studies showing that exposure to the chemicals in cigarette smoke can retard fetal growth or cause stillbirths.

By: William Feiner

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