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Dr. H. Wakeham R. Fagan 4Z,4'~*- Smoking in Pregnancy: A Prospective Study Done In Britain Brit. J. Prev. Soc. Med. (1968) 22: 119-126 infant? .'1`he present paper tries to answer the f irst question smolting, per se? (b) Is being smaller a disadvantage to the don't smoke, two questions arise: (a) Is this a consequence of }. Since mothers who smoke have smaller babies than mothers who Mothers were divided in five groups: I. non-smokers; II. occasional collection period expired were children matched with mothers. imarily.- The study spread over a 4-5 year period and mothers weree studied separately from the children and only after the data ;=s` smokers; 111. redular smokers of f ive cigarets a day; IV. regular smokers of ten cigarets a day; V. smokers of twenty or more -that non-smokers and occasional smokers were conntderect rn- ,cigarets a day. For analytical purposes these.were combined so :'gether and called non-smokers and smokers were the regular smkers. a) Mothers who smoke had a lower blood pressure than mothers who didn't smoke, than mother who smokes. paternal age, socto-erg ~omic status, educational level, maternal height, parity, etc.,~:: non-spnoking mother has a heavier baby c) Taking Into consideration many factors such as maternal age, tion of 48, 500 pregnancies. (Ob. and Gyn. 29: 1-8, jan., 1967. pregnancies (abortion, still-btrth, and neo-natal deaths taken together). This Is different from an American study which failed to show an increased perinatal mortality in an examina- . b) Mothers who snzoke have a higher percentage of unsuccessful In babies of smoking and non-smoking mothers. d) Apgar scores (a measure of congenital anomalies) is no different - faster than babies born to non-smoking mothers. By the end of e) Babies born to smoking mothers grow faster and put on wetaht

January 10, 1969 the first year, the babies seem to be similar in weight and growth. The lower birth weight of babies born to smoking mothers Is attributed to the toxic effects of smoko, particularly the carbon monoxide. V: uterine blood vessels and hence cutting down on blood supply avail- 5. Fasaman#ck "and Knobloch who have studied effects of prematurity on child developtnent point to some effects of cigaret smoking in the production of premature tnfants as defined by birth weight. (Birth weights under 5 pounds are considered premature births. ) They attribute this effect to the lower nourishment of the fetus through one of two mechanisms: (a) effect- of nicotine In constricting the factor to postnatal intellectual dev( lopment. heavier twin had the better circulation) and that this was a contributing that there was a difference in prenatal circulatory relationship (the ' weight was 400 grams or more. The authors Interpret this to mean the heavier twin. This was particularly true when the difference in later Intellectual developnents. An analysis of over 800 pairs tested befori'the age o€10 showed a higher score on the Intelligence test for 4. A paper delivered by Kaeiber and Pugh of Harvard at the 96th AnnuaZ. Meeting of the American Public Health Association addressed Itself to the pproblenz of birth weight and Intelligence test scores. In an intra- pait< comparison of birth weight of twins, the authors sought to deter- rnine whether differences in weight are predictive of differences in able to the fetus @1t (b) to the effect of smoking In reducing the appetite of the mother and hence the supply of nutriments, particularly proteins, to the €etus. They find that premature babies are more likely in later life to have physiological and psychological problems. appetite of the mother (hence poor nutrition) Is yet to be decided. by Russell et al or whether the mechanism Is through the reduced 6. All the investigations of this type agree that smoking mothers have babies of lower birth weight than non-smoking mothers, and that these lower weight babies are more likely to experience problems later in life. Whether the mechanism is that of a "slight poison" as suggested