Fathers-to-be who smoke may harm their babies

Fathers-to-be, take note! Smoking may increase the baby's risk of developing congenital heart defects―the leading cause of stillbirth, a study has found.

Congenital heart affect eight in 1,000 babies born worldwide. Prognosis and quality of life continues to improve with innovative surgeries, but the effects are still lifelong.

The findings suggest that fathers-to-be should quit smoking.

“Fathers are a large source of second hand smoke for pregnant women, which appears to be even more harmful to unborn children than women smoking themselves,” said a researcher.

“Smoking is teratogenic, meaning it can cause developmental malformations. The association between prospective parents smoking and the risk of congenital heart defects has attracted more and more attention with the increasing number of smokers of childbearing age,” he said.

All types of parental smoking were associated with the risk of congenital heart defects, with an increase of 74 per cent for men smoking, 124 per cent for passive smoking in women, and 25 per cent for women smoking, compared to no smoking exposure.

This was also the first review to examine smoking at different stages of pregnancy and risk of congenital heart defects.

Women's exposure to secondhand smoke was risky for their offspring during all stages of pregnancy and even prior to becoming pregnant. Women who smoked during pregnancy had a raised likelihood of bearing a child with a congenital heart defect, but smoking before pregnancy did not affect risk.

“Women should stop smoking before trying to become pregnant to ensure they are smoke-free when they conceive,” he said.

“Staying away from people who are smoking is also important. Employers can help by ensuring that workplaces are smoke-free,” he said.

“Doctors and primary healthcare professionals need to do more to publicise and educate prospective parents about the potential hazards of smoking for their unborn child,” he said.

Regarding specific types of congenital heart defects, the analysis showed that maternal smoking was significantly associated with a 27 per cent greater risk of atrial septal defect and a 43 per cent greater risk of right ventricular outflow tract obstruction compared to no smoking.

The overall risk of congenital heart defects with all types of parental smoking was greater when the analysis was restricted to Asian populations.

According to researchers, this was the first meta-analysis to examine the relationships between paternal smoking and maternal passive smoking and risk of congenital heart defects in offspring.
Previous analyses have focused on women smokers.

“In fact, smoking in fathers-to-be and exposure to passive smoking in pregnant women are more common than smoking in pregnant women,” he said.

The researchers compiled the best available evidence up to June 2018. This amounted to 125 studies involving 1,37,574 babies with congenital heart defects and 8.8 million prospective parents.

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Smoke-free policies linked to lower blood pressure among non-smokers

A recent study as observed that smoke-free policies in public spaces are associated with lower blood pressure readings among non-smokers. While smoke-free policies and laws that prohibit smoking in public places like bars and restaurants have been associated with reduced rates of hospitalisation for heart disease, previous studies have not examined changes in blood pressure.
 
"We found that nonsmoking adults in the study who lived in areas with smoke-free laws in restaurants, bars or workplaces had lower systolic blood pressure by the end of the follow-up period compared to those who lived in areas without smoke-free laws," said the lead author of the study.

Smoke-free laws were associated with reduced systolic blood pressure, but surprisingly not with reductions in diastolic blood pressure or high blood pressure. It's not entirely certain why this was the case, but it's possible that we are detecting effects on systolic blood pressure that are below the threshold for hypertension, the Dr. added.

Higher systolic blood pressure increases the risk of cardiovascular disease even when they are below the hypertension threshold, so the reductions in systolic blood pressure seen in this study suggest a potentially meaningful effect on population-level risk, she said.

"Also, when we looked at differences in blood pressure over time within individuals, comparing years when they lived in an area with a smoke-free law to years when they didn't, systolic blood pressure was lower on average when they lived in an area with smoke-free laws, after accounting for overall trends in blood pressure and for how people's levels of risk factors like diet and physical activity changed over the study period," she explained.

While the magnitude of associations was small at the individual level, researchers said the results point to a potential mechanism through which reductions in secondhand smoke, due to smoke-free policies, may improve population-level heart health. 

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