A re-examination of data from earlier studies suggests that exposure to second-hand smoke during pregnancy can be just as detrimental to a developing fetus as primary exposure through maternal smoking, according to a recent paper from the University of Pittsburgh Graduate School of Public Health.
In a study published in the online journal BMC Pediatrics, Stephen G. Grant, Ph.D., associate professor of environmental and occupational health, reports that both active maternal smoking and secondary maternal exposure result in similarly increased rates of genetic mutation that are basically indistinguishable.
"This analysis shows not only that smoking during pregnancy causes genetic damage in the developing fetus that can be detected at birth, but also that passive - or secondary - exposure causes just as much damage as active smoking, and it is the same kind of damage," said Dr. Grant, whose primary area of study is genotoxicity and the mechanisms of DNA repair. "These kinds of mutations are likely to have lifelong repercussions for the exposed fetus, affecting survival, birth weight and susceptibility to disease, including cancer."
This is a startlingly different conclusion than that reached by three previous studies looking at the potential effects of tobacco smoke exposure to babies in the womb, one of which Dr. Grant co-authored. The primary papers largely discounted the effects of secondary - and sometimes even direct exposure through maternal smoking - or produced contradictory results.
The original studies looked at mutation rates at the HPRT gene located on the X chromosome in cord blood samples from newborns. Dr. Grant's analysis pooled the studies' data, looking for frequency of induced mutation as well as the resulting molecular spectrum of mutations. In particular, the new analysis redefines the "non-smokers" used as controls to consider their second-hand exposure to tobacco smoke through other family members at home, at work or in social situations at restaurants or even outdoors.
"Moreover, we found similarly increased induced mutation in women who had quit smoking during pregnancy, usually when they found out they were pregnant," said Dr. Grant, who also is an assistant investigator at the Magee-Womens Research Institute. "Perhaps, like certain pharmaceutical warnings, it would be appropriate to caution women to quit smoking if they are pregnant or likely to become pregnant. It is equally imperative that workplace protection be offered to reduce passive exposure."
This study was supported by funding from the National Institute of Child Health and Human Development and the University of Pittsburgh Competitive Medical Research Fund.
Founded in 1948 and fully accredited by the Council on Education for Public Health, GSPH is world-renowned for contributions that have influenced public health practices and medical care for millions of people. One of the top-ranked schools of public health in the United States, GSPH was the first fully accredited school of public health in the Commonwealth of Pennsylvania, with alumni who are among the leaders in their fields of public health. A member of the Association of Schools of Public Health, GSPH currently ranks third among schools of public health in NIH funding received. The only school of public health in the nation with a chair in minority health, GSPH is a leader in research related to women's health, HIV/AIDS and human genetics, among others. For more information about GSPH, visit the GSPH Web site at http://www.publichealth.pitt.edu.
Note to reporters: A pdf version of the study is available by calling Michele D. Baum at (412) 647-3555 or e-mailing a request to BaumMD@upmc.edu. The study also is available for download at biomedcentral.com/bmcpediatr.
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