EFFECT OF SMOKING ON PREGNANCY COURSE AND OUTCOME: A PROSPECTIVE COHORT

Objective: To look for hazards of smoking during pregnancy on pregnancy outcome. Methods: It is a prospective cohort study, conducted at gynecology department, Nishtar hospital, Multan, Pakistan. Pregnant mothers were asked about smoking status, course of pregnancy, pregnancy outcome, age, parity, hypertension, age, mode of delivery, any complication during pregnancy. Similar variables were inquired about in non smokers. Results: Total 70 patients were studied and they were between 18 to 45 years of age. There were 45 smokers, 60% of total, 2 pack year. 12 with 4 pack years, 16.9%, 4(5.6%) with 6 pack years and 11(15.5%) with 10 pack years. 18 were primi-gravida and 52 were multi-gravida, 25.4% and 73.7% respectively. 8 were hypertensive (11.3%), 69 were anemic (97.2%), 31 had complicated pregnancy course 43.7% while 39 had normal pregnancy course (59.9%). The complications associated with 43.7% of study population were breech presentation in 4, pelvic pain in 9, abruption placenta in 2, placenta previa in 5, PV bleeding in 3, preterm labor in 9, while one patient with pre-eclampsia, transverse fetal position and low apgar score. 43 patients underwent cessarian delivery while remaining delivered through vagina. 15.5% fetus were aborted, one died while 58 remained alive. Among non-smoker population, 35(50%) were anemic, postpartum 24(34%), pre-eclamptic 7(10%), 16(22%) PIH, 24(34%) delivered through cessarian section, abortions in 2%. Conclusion: smoking increases risk of anemia and cessarian delivery and on neonatal outcome it has adverse effects like more abortion ratio, more neonatal deaths. Key Words: smoking, mothers, neonate, pregnancy, health, hazards