[Smoking-related biological alterations in women: a way to start talking about smoking. The internist's point a view: the clinical biologist's point of view].
Besides biological markers such as cotinine, CO, and thiocyanate, other biological parameters are altered during pregnancy in women who smoke. Smoking women generally have a high white cell count which is related in part to pregnancy and in part to smoking but independently of other conditions. The mean corpuscular volume is increased, even in the absence of folate deficiency frequent in smoking pregnant women. The platelet count is higher than in the non-smoking mothers and the physiological pregnancy-related hyperaggregability is increased. The hypercoagulability status during pregnancy does not appear to be worsened by smoking but is insufficiently counterbalanced by fibrolysis which is less active in the smoking pregnant woman. These factors increase the risk of venous thrombosis which remains one of the main factors of pregnancy-related mortality. There are also smoking-related lipid metabolism disorders which appear independently of the pregnancy-related variations: increased total cholesterol, LDL cholesterol, and triglycerides and decreased HDL cholesterol. Combined, these factors can have an effect on the arterial walls. Vitamin levels are also lower in smoking mothers compared with their non-smoking counterparts. Levels of vitamins C, A, B12 and folates are decreased. Finding these anomalies during pregnancy in smoking mothers can be a useful mean of inciting them to stop smoking.
Laboratoire d'Hématologie, Université René-Descartes, Hôpital Necker Enfants Malades, 149, rue de Sèvres, 75015 Paris.
M-D
MD
Dautzenberg
D001695:Biology; D001772:Blood Cell Count; D001778:Blood Coagulation Disorders / Q000209:etiology; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D007388:Internal Medicine; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects / Q000097:blood*; D000074606:Smoking Prevention