[Effect of smoking on mode of delivery and per partum hypoxia and acidosis].
METHODS
We conducted a PubMed research using the following key words: fetal, smoking, distress, hypoxia, acidosis, heart rate, cesarean.


RESULTS
The different combinations of key works allowed selection of 251 since 1967. Several article were addressed directly to the question raised; two for meconial fluid alone. One article detailed possible method biases. Several articles detailed the Apgar score in newborns of smoking mothers. Three calculated the risk of cesarean section in smokers.


CONCLUSIONS
Data in the literature is not sufficient to argue in favor of an association between fetal asphyxia during labor and smoking. Only one study showed a higher rate of cesarean section in mothers smoking more than 10 cigarettes per day. Nevertheless, the Apgar score does not appear to be modified by moderate maternal smoking. Paradoxically, maternal smoking could have a protective effect on meconial aspiration and could have a moderately reducing effect on the rate of cesarean section during labor in patients smoking less than 10 cigarettes per day via lower fetal weight. These findings should be examined with caution because they still need to be confirmed and do not take into consideration other adverse effects of smoking on the fetus.
Grangé
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Maternité Port Royal, Groupe Hospitalier Cochin - Saint-Vincent-de-Paul, 123, boulevard de Port-Royal, 75014 Paris.
Pannier
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E
D000138:Acidosis / Q000209:etiology*; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects*