World No Tobacco day -WNTD" is celebrated all over the world every year on 31st May since 1987 to promote " No Tobacco" of any form for 24 hrs. & is symbolically represented by 'Ash trays with fresh flowers'.
The day is intended to bring awareness about the widespread use of tobacco & its ill effects on health including ~6million deaths every year of which 600000 are passive smokers.
Tobacco abuse in pregnancy is at an increasing trend especially in developing countries & could be double edged as it affect badly both mother and the baby. Incidence varies from 15-50% (James Walker) although 30% reduction rate is expected during the course of pregnancy. Smoking in pregnancy is seen in all socio economic groups & can be associated with alcohol abuse, malnutrition, psychological illness.
Effect of smoking ON PREGNANCY depends on - the age of the mother, number of cigarettes she smokes per day & the duration in pregnancy she smokes.
Smoking affects the blood circulation & oxygen supply, hence placental complications like - missed abortions, placenta previa, placental abruption, preterm delivery, growth restriction, stillbirths are common. High incidence of birth defects like cleft lip, cleft palate, gastrointestinal abnormalities, and lung & heart problems has been reported. Smoking should be stopped at any cost at the onset of labor. Close monitoring during labor is mandatory. General anaesthesia may pose problem in pregnant smokers, so also the risk of thromboembolism.
Neonatal complications include small for date babies, neurological, behavioural, intellectual impairment & sudden infant death syndrome -SIDS & asthma
Age old proverb "Prevention is better than cure” holds good in the management & demands multidisciplinary approach which includes obstetricians, midwives, counsellor, neonatologist, fetal medicine specialist, social support group &family.
REPEATED encouragement & counseling approach is beneficial in both educated & uneducated smokers. Best is to stop smoking before pregnancy .If not.....stopping even by mid pregnancy has positive health effect on unborn babies. Relapse of smoking during late pregnancy & post-delivery is common in -High grade smokers with low education level, alcohol abuse, smoking partner & older age group. Innocent newborns can be a passive smoker risking “sudden infant death syndrome”
Needless to say that smoking is associated with increase in long term morbidity and mortality of the mother. Other noted effects of smoking on women include Infertility, lung cancer, breast cancer, cancer cervix, mucinous ovarian cancer, colon cancer, early menopause, delayed wound healing, gum diseases, dental problems, stomach ulcers, cataract, Rhematoid arthritis, lower bone density, stroke, heart disease!
With this information... Lets all join together to motivate deaddiction BEFORE PREGNANCY & SAY GOOD BYE to relapse anytime later... So that
"WE MAKE EVERYDAY WORLD NO TOBACCO DAY"
Dr. Shobha Venkat
(Sr. Consultant Obstetrician & Gynaecologist, Cloudnine Hospital, Old Airport Road, Bengaluru)
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