Some Birth Defects Linked to Mothers Who Smoke

One of the first things every new parent does is count the baby's fingers and toes. But, women who smoke during pregnancy may be in for an unhappy surprise, because smoking increases the odds that a baby will be born with finger or toe deformities.

Just a half a pack a day increased the risk of having a baby with extra, missing, or webbed fingers or toes by nearly 30 percent, according to a report in the journal Plastic and Reconstructive Surgery.

"One of the things that smoking does is interfere with oxygen delivery to cells at very key moments in development," explains Dr. Manuel Alvarez of Hackensack University Medical Center.

"If cells are deprived of oxygen, they don't proliferate as they should. If cells don't proliferate, you can have limb deformities," he says.

Risk Increases With Every Cigarette

About one out of every nine expectant mothers smokes, according to the March of Dimes. If no pregnant woman smoked, the rate of stillbirths would drop by 11 percent, and newborn deaths would decrease by about 5 percent.

Smoking also increases the risk of preterm birth, a low birth-weight baby, and cerebral palsy in the baby.

Limb defects are not uncommon. Missing toes or fingers is known as adactyly. About one in 600 babies is born with an extra finger or toe - a condition known as polydactyly. A baby born with webbed toes or fingers - syndactyly - occurs in about one in every 2,000 to 2,500 births.

Webbed fingers or toes are more common in Caucasian babies, while excess digits are more common in African-American babies.

Most of the time, these deformities occur in babies with no family history of such birth defects, which led researchers to suspect environmental causes.

After sifting through almost 7 million birth records from 2001 to 2002, researchers from the University of Pennsylvania found almost 5,200 babies born to women who smoked who also had deformed fingers or toes.

None of the women who smoked had other medical conditions, such as high blood pressure or diabetes.

The researchers found that the more a woman smoked, the greater the likelihood of finger or toe anomalies.

Women who smoked more than a pack a day had a 78 percent increased risk of having a baby with deformed toes or fingers, while women who smoked 11 to 20 cigarettes daily had a 38 percent increased risk.

Those who smoked 10 or fewer cigarettes a day upped their babies' risk by 29 percent.

"This is another reason to stop smoking," says Dr. Alfred Robichaux III of Ochsner Health System. "The problems with smoking during pregnancy are increased bleeding, miscarriage, premature deliveries, and low birth weight.

“Babies born to mothers [who are] smokers have higher respiratory illnesses and lower IQs,” says Dr. Robichaux. “They also have a higher rate of SIDS [sudden infant death syndrome]. And, now we have evidence that they have up to a 30 percent increase in limb defects.

"Thankfully, surveys are showing that the rate of smoking during pregnancy is on the decline. It looks like the word is getting out," Dr. Robichaux adds.

Doctors Want to Help Women Quit

Dr. Robert Welch of Providence Hospital in Southfield, Mich., says he was not surprised by this study's findings, since previous research has linked smoking to an increased risk of cleft lip and palette.

He says the best thing a woman can do is quit smoking before she gets pregnant.

"If you're contemplating pregnancy, that's when you want to stop," advises Dr. Welch. However, both Drs. Welch and Alvarez point out that it is never too late for a pregnant woman to stop - or at the very least cut down - on her smoking.

"We encourage women with each prenatal visit and may shorten the time between prenatal visits for extra support,” says Dr. Welch. “We recommend smoking reduction with the idea that it will lead to cessation.”

Both experts say nicotine replacement products are not recommended for pregnant women, but that many women have success quitting smoking using acupuncture.

Both Drs. Welch and Alvarez say it is key for the woman's partner to quit smoking as well or stay away while smoking.

What is most important, says Dr. Alvarez, is to be upfront with your doctor about your smoking habit.

"I would rather know the truth, so I know why the baby isn't growing adequately,” says Dr. Alvarez. “Tell me that you're having major difficulty quitting, and we can work on breaking the habit.”

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Academy of Family Physicians

American Pregnancy Association

CDC - You Can Quit Smoking Consumer Guide

March of Dimes

National Institutes of Health (NIH)

National Women's Health Information Center

Plastic and Reconstructive Surgery - Maternal Cigarette Smoking during Pregnancy Increases the Risk of Having a Child with a Congenital Digital Anomaly

November 2007

Some Birth Defects Linked to Mothers Who Smoke

Risk Increases With Every Cigarette

Doctors Want to Help Women Quit

Planning for Pregnancy

Online Resources

Planning for Pregnancy

If you are planning to become pregnant, taking certain steps can help reduce risks to both you and your baby.

Proper health before deciding to become pregnant is almost as important as maintaining a healthy body during pregnancy.

The first few weeks are crucial in a child's development. However, many women do not realize they are pregnant until several weeks after conception.

Planning ahead and taking care of yourself before becoming pregnant is the best thing you can do for you and your baby.

One of the most important steps in helping you prepare for a healthy pregnancy is a pre-pregnancy examination (often called preconceptual care) performed by your physician before you become pregnant.

If you are a smoker, stop smoking now. Studies have shown that babies born to mothers who smoke tend to be lower in birthweight.

In addition, exposure to secondhand smoke may adversely affect the fetus.

Eating a balanced diet before and during pregnancy is not only good for the mother's overall health, but essential for nourishing the fetus.

It is important to exercise regularly and maintain a proper weight before and during pregnancy.

Women who are overweight may experience medical problems such as high blood pressure and diabetes. Women who are underweight may have babies with low birthweight.

Take control of any current or preexisting medical problems, such as diabetes or high blood pressure.

Take 400 micrograms (0.4 mg) of folic acid each day, a nutrient found in some green, leafy vegetables, nuts, beans, citrus fruits, fortified breakfast cereals, and some vitamin supplements.

Folic acid can help reduce the risk of birth defects of the brain and spinal cord (also called neural tube defects).

Avoid exposure to alcohol and drugs during pregnancy. In addition, be sure to inform your physician of any medications (prescription and over-the-counter) you are currently taking - all may have adverse effects on the developing fetus.

Pregnant women should avoid exposure to toxic and chemical substances (i.e., lead and pesticides), and radiation (i.e., x-rays).

Pregnant women should avoid the ingestion of undercooked meat and raw eggs.

Begin taking a prenatal vitamin daily, prescribed by your physician, to make certain that your body gets all the necessary nutrients and vitamins needed to nourish a healthy baby.

Always consult your physician for more information.