The effect of smoking on glucose homeostasis and fetal growth in pregnant women.
OBJECTIVE
To examine the relationship between maternal blood glucose levels, cigarette smoking in pregnancy and fetal growth.


METHODS
A prospective study of healthy parous women from early pregnancy and their infants.


METHODS
Three Scandinavian university hospitals covering all deliveries from well defined geographical areas.


METHODS
Study groups of non-smoking (150), light smoking (131) and heavily smoking mothers (218), para 1 and 2 and with > 37 weeks of gestational length.


METHODS
Oral glucose tolerance test performed in pregnancy week 37, glycated hemoglobin measured the 3rd day post partum and neonatal anthropometric parameters including skinfold measurements.


RESULTS
Among heavily smoking mothers 12.4% displayed a 2-hour glucose value in the range of gestational diabetes (> 8.5 mmol/l) compared to 9.2% among light smokers and 6.0% among nonsmokers (p < 0.05). Heavily smoking mothers also had significantly (p < 0.05) higher glycated hemoglobin compared to nonsmokers, 5.01 v.s. 4.86. These changes in glucose parameters in smokers were not associated with higher birthweights.


CONCLUSIONS
Smoking in pregnancy affects parameters of glucose homeostasis in the direction of gestational diabetes. The retarding effect of smoking on fetal growth abolished any expected growth stimulation from the higher blood glucose levels seen in the smokers.
Zarén
B
B
Department of Womnen's and Children's Health, University Hospital, Uppsala, Sweden.
Lindmark
G
G
Wibell
L
L
Følling
I
I
D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000209:etiology; D005314:Embryonic and Fetal Development; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006706:Homeostasis; D006801:Humans; D016014:Linear Models; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects*
D001786:Blood Glucose; D006442:Glycated Hemoglobin