Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers
Objectives To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers. Design Prospective cohort study. Setting Auckland, New Zealand and Adelaide, Australia. Population Nulliparous participants in the Screening for Pregnancy Endpoints (SC...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2009-09, Vol.116 (10), p.1300-1306 |
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| creator | Kho, EM North, RA Chan, E Stone, PR Dekker, GA McCowan, LME |
| description | Objectives To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers.
Design Prospective cohort study.
Setting Auckland, New Zealand and Adelaide, Australia.
Population Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study.
Methods Self‐reported smoking status was determined at 15 ± 1 weeks’ gestation. At the 20 ± 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers.
Main outcomes measures Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry.
Results Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P |
| doi_str_mv | 10.1111/j.1471-0528.2009.02266.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67595898</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67595898</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4906-69e2b8d5b268c528f27d04c76b2f1db143de533c6201093e849d70c431afd6cb3</originalsourceid><addsrcrecordid>eNqNkc9u1DAQxi1ERf_AKyALCW5JbSd2nAMHWAotqtQLnC3HGS_eOvFiZ7tdTki8KU-C010ViRO-eKT5zeib70MIU1LS_M5XJa0bWhDOZMkIaUvCmBDl_RN08th4-lCTglRMHqPTlFaEUMFI9Qwd05YLwSU7QW7xTY9LSNiN-ENYrz1EbH3Y4jvwwbhph7f6DmyIQ8J67LGFSXuc3A_AesKM_P75awtwm3DeMenJhRHrIYxLbNxSR5gmwGkItxDTc3RktU_w4vCfoa8fL74sLovrm09Xi3fXhalbIgrRAutkzzsmpMlnWNb0pDaN6JilfUfrqgdeVSZfQklbgazbviGmrqi2vTBddYbe7PeuY_i-yarU4JIB7_UIYZOUaHjLZSsz-OofcBU2cczaFGOcS1KLOkNyD5kYUopg1Tq6QcedokTNWaiVmi1Xs-VqzkI9ZKHu8-jLw_5NN0D_d_BgfgZeHwCdjPY26tG49MgxKhkndObe7rmt87D7bwHq_eebuar-AO_MpUw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>225580464</pqid></control><display><type>article</type><title>Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Kho, EM ; North, RA ; Chan, E ; Stone, PR ; Dekker, GA ; McCowan, LME</creator><creatorcontrib>Kho, EM ; North, RA ; Chan, E ; Stone, PR ; Dekker, GA ; McCowan, LME ; SCOPE consortium ; on behalf of the SCOPE consortium</creatorcontrib><description>Objectives To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers.
Design Prospective cohort study.
Setting Auckland, New Zealand and Adelaide, Australia.
Population Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study.
Methods Self‐reported smoking status was determined at 15 ± 1 weeks’ gestation. At the 20 ± 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers.
Main outcomes measures Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry.
Results Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P < 0.0001] and mean uterine RI [0.59 (0.09) versus 0.56 (0.10), P < 0.0001]. They were twice as likely to have an abnormal umbilical Doppler at 20 weeks compared with nonsmokers [n = 35 (14.6%) versus n = 156 (7.2%), OR 2.21, 95% CI 1.49–3.27]. This effect remained significant after adjusting for age, ethnicity, marital status, employment and BMI (adjusted OR 1.62, 95% CI 1.03–2.54). Smokers were more likely to have an abnormal mean uterine RI [n = 33 (13.7%) versus n = 198 (9.2%), OR 1.57, 95% CI 1.06–2.33], but this association was not significant after adjusting for confounders. Fetuses of women who smoked had a small reduction in femur length and estimated weight compared with nonsmokers.
Conclusions At 20 weeks’ gestation, women who smoke have higher umbilical artery RI, a surrogate measure for an abnormal placental villous vascular tree. This may contribute to later fetal growth restriction among smokers. Further research is needed to explore the clinical significance of these findings.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/j.1471-0528.2009.02266.x</identifier><identifier>PMID: 19566582</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Biological and medical sciences ; Blood Flow Velocity - physiology ; Body Size ; Cardiovascular system ; Comparative studies ; Doppler ; Female ; Fetal Development - physiology ; fetal growth ; Fetal Growth Retardation - diagnostic imaging ; Fetal Growth Retardation - physiopathology ; Fetuses ; Gynecology. Andrology. Obstetrics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical imaging ; Medical sciences ; Microscopy, Acoustic ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal development ; Prospective Studies ; small for gestational age ; Smoking ; Smoking - physiopathology ; Ultrasonic investigative techniques ; Ultrasonography, Doppler - methods ; Ultrasonography, Prenatal - methods ; Umbilical Arteries - diagnostic imaging ; Umbilical Arteries - physiology ; Uterus - blood supply ; Vascular Resistance - physiology ; Veins & arteries ; Young Adult</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2009-09, Vol.116 (10), p.1300-1306</ispartof><rights>2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology</rights><rights>2009 INIST-CNRS</rights><rights>Journal compilation © 2009 RCOG</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4906-69e2b8d5b268c528f27d04c76b2f1db143de533c6201093e849d70c431afd6cb3</citedby><cites>FETCH-LOGICAL-c4906-69e2b8d5b268c528f27d04c76b2f1db143de533c6201093e849d70c431afd6cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1471-0528.2009.02266.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1471-0528.2009.02266.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21825012$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19566582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kho, EM</creatorcontrib><creatorcontrib>North, RA</creatorcontrib><creatorcontrib>Chan, E</creatorcontrib><creatorcontrib>Stone, PR</creatorcontrib><creatorcontrib>Dekker, GA</creatorcontrib><creatorcontrib>McCowan, LME</creatorcontrib><creatorcontrib>SCOPE consortium</creatorcontrib><creatorcontrib>on behalf of the SCOPE consortium</creatorcontrib><title>Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objectives To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers.
Design Prospective cohort study.
Setting Auckland, New Zealand and Adelaide, Australia.
Population Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study.
Methods Self‐reported smoking status was determined at 15 ± 1 weeks’ gestation. At the 20 ± 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers.
Main outcomes measures Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry.
Results Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P < 0.0001] and mean uterine RI [0.59 (0.09) versus 0.56 (0.10), P < 0.0001]. They were twice as likely to have an abnormal umbilical Doppler at 20 weeks compared with nonsmokers [n = 35 (14.6%) versus n = 156 (7.2%), OR 2.21, 95% CI 1.49–3.27]. This effect remained significant after adjusting for age, ethnicity, marital status, employment and BMI (adjusted OR 1.62, 95% CI 1.03–2.54). Smokers were more likely to have an abnormal mean uterine RI [n = 33 (13.7%) versus n = 198 (9.2%), OR 1.57, 95% CI 1.06–2.33], but this association was not significant after adjusting for confounders. Fetuses of women who smoked had a small reduction in femur length and estimated weight compared with nonsmokers.
Conclusions At 20 weeks’ gestation, women who smoke have higher umbilical artery RI, a surrogate measure for an abnormal placental villous vascular tree. This may contribute to later fetal growth restriction among smokers. Further research is needed to explore the clinical significance of these findings.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Body Size</subject><subject>Cardiovascular system</subject><subject>Comparative studies</subject><subject>Doppler</subject><subject>Female</subject><subject>Fetal Development - physiology</subject><subject>fetal growth</subject><subject>Fetal Growth Retardation - diagnostic imaging</subject><subject>Fetal Growth Retardation - physiopathology</subject><subject>Fetuses</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Microscopy, Acoustic</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, Second</subject><subject>Prenatal development</subject><subject>Prospective Studies</subject><subject>small for gestational age</subject><subject>Smoking</subject><subject>Smoking - physiopathology</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography, Doppler - methods</subject><subject>Ultrasonography, Prenatal - methods</subject><subject>Umbilical Arteries - diagnostic imaging</subject><subject>Umbilical Arteries - physiology</subject><subject>Uterus - blood supply</subject><subject>Vascular Resistance - physiology</subject><subject>Veins & arteries</subject><subject>Young Adult</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQxi1ERf_AKyALCW5JbSd2nAMHWAotqtQLnC3HGS_eOvFiZ7tdTki8KU-C010ViRO-eKT5zeib70MIU1LS_M5XJa0bWhDOZMkIaUvCmBDl_RN08th4-lCTglRMHqPTlFaEUMFI9Qwd05YLwSU7QW7xTY9LSNiN-ENYrz1EbH3Y4jvwwbhph7f6DmyIQ8J67LGFSXuc3A_AesKM_P75awtwm3DeMenJhRHrIYxLbNxSR5gmwGkItxDTc3RktU_w4vCfoa8fL74sLovrm09Xi3fXhalbIgrRAutkzzsmpMlnWNb0pDaN6JilfUfrqgdeVSZfQklbgazbviGmrqi2vTBddYbe7PeuY_i-yarU4JIB7_UIYZOUaHjLZSsz-OofcBU2cczaFGOcS1KLOkNyD5kYUopg1Tq6QcedokTNWaiVmi1Xs-VqzkI9ZKHu8-jLw_5NN0D_d_BgfgZeHwCdjPY26tG49MgxKhkndObe7rmt87D7bwHq_eebuar-AO_MpUw</recordid><startdate>200909</startdate><enddate>200909</enddate><creator>Kho, EM</creator><creator>North, RA</creator><creator>Chan, E</creator><creator>Stone, PR</creator><creator>Dekker, GA</creator><creator>McCowan, LME</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200909</creationdate><title>Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers</title><author>Kho, EM ; North, RA ; Chan, E ; Stone, PR ; Dekker, GA ; McCowan, LME</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4906-69e2b8d5b268c528f27d04c76b2f1db143de533c6201093e849d70c431afd6cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Body Size</topic><topic>Cardiovascular system</topic><topic>Comparative studies</topic><topic>Doppler</topic><topic>Female</topic><topic>Fetal Development - physiology</topic><topic>fetal growth</topic><topic>Fetal Growth Retardation - diagnostic imaging</topic><topic>Fetal Growth Retardation - physiopathology</topic><topic>Fetuses</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Microscopy, Acoustic</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, Second</topic><topic>Prenatal development</topic><topic>Prospective Studies</topic><topic>small for gestational age</topic><topic>Smoking</topic><topic>Smoking - physiopathology</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography, Doppler - methods</topic><topic>Ultrasonography, Prenatal - methods</topic><topic>Umbilical Arteries - diagnostic imaging</topic><topic>Umbilical Arteries - physiology</topic><topic>Uterus - blood supply</topic><topic>Vascular Resistance - physiology</topic><topic>Veins & arteries</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kho, EM</creatorcontrib><creatorcontrib>North, RA</creatorcontrib><creatorcontrib>Chan, E</creatorcontrib><creatorcontrib>Stone, PR</creatorcontrib><creatorcontrib>Dekker, GA</creatorcontrib><creatorcontrib>McCowan, LME</creatorcontrib><creatorcontrib>SCOPE consortium</creatorcontrib><creatorcontrib>on behalf of the SCOPE consortium</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kho, EM</au><au>North, RA</au><au>Chan, E</au><au>Stone, PR</au><au>Dekker, GA</au><au>McCowan, LME</au><aucorp>SCOPE consortium</aucorp><aucorp>on behalf of the SCOPE consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2009-09</date><risdate>2009</risdate><volume>116</volume><issue>10</issue><spage>1300</spage><epage>1306</epage><pages>1300-1306</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objectives To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers.
Design Prospective cohort study.
Setting Auckland, New Zealand and Adelaide, Australia.
Population Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study.
Methods Self‐reported smoking status was determined at 15 ± 1 weeks’ gestation. At the 20 ± 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers.
Main outcomes measures Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry.
Results Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P < 0.0001] and mean uterine RI [0.59 (0.09) versus 0.56 (0.10), P < 0.0001]. They were twice as likely to have an abnormal umbilical Doppler at 20 weeks compared with nonsmokers [n = 35 (14.6%) versus n = 156 (7.2%), OR 2.21, 95% CI 1.49–3.27]. This effect remained significant after adjusting for age, ethnicity, marital status, employment and BMI (adjusted OR 1.62, 95% CI 1.03–2.54). Smokers were more likely to have an abnormal mean uterine RI [n = 33 (13.7%) versus n = 198 (9.2%), OR 1.57, 95% CI 1.06–2.33], but this association was not significant after adjusting for confounders. Fetuses of women who smoked had a small reduction in femur length and estimated weight compared with nonsmokers.
Conclusions At 20 weeks’ gestation, women who smoke have higher umbilical artery RI, a surrogate measure for an abnormal placental villous vascular tree. This may contribute to later fetal growth restriction among smokers. Further research is needed to explore the clinical significance of these findings.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19566582</pmid><doi>10.1111/j.1471-0528.2009.02266.x</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Blood Flow Velocity - physiology Body Size Cardiovascular system Comparative studies Doppler Female Fetal Development - physiology fetal growth Fetal Growth Retardation - diagnostic imaging Fetal Growth Retardation - physiopathology Fetuses Gynecology. Andrology. Obstetrics Humans Investigative techniques, diagnostic techniques (general aspects) Medical imaging Medical sciences Microscopy, Acoustic Pregnancy Pregnancy Trimester, Second Prenatal development Prospective Studies small for gestational age Smoking Smoking - physiopathology Ultrasonic investigative techniques Ultrasonography, Doppler - methods Ultrasonography, Prenatal - methods Umbilical Arteries - diagnostic imaging Umbilical Arteries - physiology Uterus - blood supply Vascular Resistance - physiology Veins & arteries Young Adult |
| title | Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers |
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