By Philip J. Goscienski, M.D – The Stone Age Doc

   Almost everyone is aware that cigarette smoking is a health hazard. Most people know that genetic factors play a role in disease. Few realize how these interact and how pregnancy sometimes depends on the interplay of lifestyle factors and the genetic makeup of the mother. A pregnant mother's lifestyle choices can lead to serious disease notonly in her infant's early childhood but in that child's middle age. That will ultimately have an effect on the national economy.

   When a pregnant woman visits her obstetrician for the first time, she is likely to hear that smoking is a hazard to the child that she is carrying. Toxic chemicals that the mother inhales while smoking enter her bloodstream and cross the placenta to the baby.

   Women who smoke during the first three months of pregnancy make it 60 percent more likely that their baby will be born with a heart defect. In the case of certain types of defects, it is 80 percent.

   Some women who smoke will deliver a child too early or one who has not reached normal size. In a study done at the Boston Medical Center, women who smoked and had gene patterns that limited their ability to detoxify chemicals in smoke were much more likely to deliver a child with low birth weight.            

   Although smoking by the mother contributes significantly to the health problems of the baby that she is carrying, exposure to someone else's smoke is also a danger. The more smokers there are in a household, the more likely it is that an infant conceived in that family will grow poorly within the womb.

   Cigarette smoking leads to premature delivery. In spite of enormous advances in newborn care, a baby that is born too early faces severe risks. Brain damage and long-term lung disease cause crippling disability and the risk increases the shorter the pregnancy. Studies that measure the actual level of a nicotine by-product in a mother's blood reveal that as these levels go up, so does the likelihood that the baby will not survive.  

   There is more to the story than small size. Late effects of growth retardation within the womb include poor school performance and attention-deficit hyperactivity disorder (ADHD). There is a higher likelihood of obesity, high blood pressure and type 2 diabetes in middle age. Babies whose weight is smaller than expected for any given stage of pregnancy are also at risk of chronic kidney disease later in life.

   Americans pay more than 100 billion dollars a year in health care costs for smokers. That doesn't include the enormous expense of the complications of obesity and type 2 diabetes, which together add more than 200 billion dollars that taxpayers will pay either in health insurance premiums, direct payment or subsidies to the uninsured.

   At least adults have a choice whether to smoke or not. Babies don't.

   Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers, 2005. Read his archived columns at  www.stoneagedoc.com. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .