Influence of smoking during pregnancy on haemostasis in healthy full term neonates.
BACKGROUND
Clinical and experimental researches have linked smoking to disturbances of coagulation and fibrinolysis. Several potential mechanisms are incriminated involving inflammation, fibrinogen synthesis and clotting factors. Based on the fact that the majority of tobacco components cross the placental barrier, the objective of our current study is to investigate the influence of smoking during pregnancy on neonatal haemostasis.


METHODS
The study was based on a comparative evaluation of coagulation and fibronolysis between healthy full term infants of women who smoked during pregnancy and a control group. Subjects consisted of 39 newborns of smoking and 43 newborns of nonsmoking mothers. Blood samples were obtained shortly after birth and before the administration of vitamin K. Investigation included: PT, INR, aPTT, fibrinogen, coagulation factors II, V, VII, VIII, IX, X, XI, XII, vWillebrand (vWF), protein C and S, APCr, anti-thrombin (AT), t-PA and PAI-1. The independent t- test was used to compare the differences between the values of coagulation and fibrinolytic parameters at the p<0.05 level.


RESULTS
We discovered a statistically significant decrease in factor II and protein S levels and an elevation in t-PA and factor VIII concentrations in newborns of smoking mothers, without clinical manifestations of altered haemostasis. There were no significant differentiations in other coagulation or fibrinolytic parameters.


CONCLUSIONS
The alteration in factor II, protein S, t-PA and factor VIII in neonates exposed in utero to tobacco smoke is not accompanied by loss in the balance between coagulation and fibrinolytic pathways.
Mitsiakos
George
G
Neonatology Department of Aristotle University of Thessaloniki, G.P.N. Papageorgiou, Thessaloniki, Greece. mga@otenet.gr
Giougi
Evaggelia
E
Papaioannou
Georgia
G
Karagianni
Paraskevi
P
Papadakis
Emmanouil
E
Nikolaidis
Nikolaos
N
D001777:Blood Coagulation / Q000187:drug effects; D001779:Blood Coagulation Factors / Q000378:metabolism; D016022:Case-Control Studies; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006487:Hemostasis / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D009538:Nicotine / Q000009:adverse effects / Q000097:blood; D011247:Pregnancy; D011446:Prospective Studies; D017293:Protein S / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D012907:Smoking / Q000009:adverse effects* / Q000097:blood*; D010959:Tissue Plasminogen Activator / Q000097:blood
D001779:Blood Coagulation Factors; D017293:Protein S; D009538:Nicotine; D011516:Prothrombin; D005169:Factor VIII; D010959:Tissue Plasminogen Activator