By Chioma Obinna
When Ngozi Ugonna’s blood laboratory test result revealed she was pregnant, her joy knew no bounds. The smile on her face as the news was broken to her after three years of childlessness was infections. No one in her family needed a soothsayer to know that something extraordinary has happened in her life.
Her husband, Eddie, was equally elated. Over and over again,he went through the lab result. He was happy that, at last, his yearning for a baby was being realised. As weeks rolled by, the hope of the couple grew.
But, unexpectedly, Ugonna’s excitement was cut short. At precisely 20 weeks gestation, she lost the pregnancy. Findings showed that a major contributor to the loss was her smoking habits. Even before marriage, Ugonna had been a heavy smoker.
She had had been smoking since her first year in the university. Efforts by her husband to make her drop the habit failed as she claimed she couldn’t do without at least a stick of cigarette every day.
But little did she know that cigarettes contain dangerous chemicals, including nicotine, carbon monoxide, and tar that can significantly increase the risk of pregnancy complications, some of which can be fatal for the mother and the baby. Simply put, cigarettes and pregnancy don’t mix.
Ugonna’s woes began one morning when she could not feel the usual movement of the foetus (baby). This prompted her visit to her doctor. The doctor listened to the baby’s heartbeat using a handheld ultrasound device called a doppler. Sadly, there was no heartbeat.
Ugonna was heartbroken. The doctor recommended an ultrasound scan immediately. Sadly, it was discovered that the baby had died. Ugonna had a stillbirth. Available statistics showed that about 1 in 160 pregnancies end in stillbirth.
According to the United States Centres for Disease Control and Prevention, CDC, smoking raises the likelihood of both early miscarriage and stillbirth. The dangerous chemicals in cigarettes are often to blame and such was the fate of Ugonna’s pregnancy.
Thousands of women are faced with the same challenge including women whose husbands are smokers or those who live in a smoking environment. Findings showed that second-hand smoke is dangerous to the foetus. Grace Egbe, 32, whose husband’s addiction to smoking almost destroyed her life and that of her unborn child, is a classic example.
Grace, a mother of two, almost lost her life while she was pregnant for her third child, no thanks to “second-hand smoke”, also called environmental tobacco smoke. Second-hand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. Second-hand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer.
Harm from ‘show of love’
Just like most pregnant women, Grace had no inclination of the negative implications of the smoke she usually inhaled while her husband smoked until she had a preterm birth.
No doubt, every couple enjoys the company of one another. Grace’s case was no different. She was always at the beck and call of the husband as they usually sat together while her husband smoked. Out of ignorance, Grace was enjoying his company even in pregnancy. But little did she know that what she termed as ‘show of love’ could harm her and her unborn child.
Five months into her pregnancy, she was diagnosed of placenta previa. Smoking has been identified as a risk factor for placenta previa. Placenta previa is when the placenta stays in the lower part of the uterus, partially or fully covering the cervix. When this happens, the placenta often tears, causing excessive bleeding and depriving the foetus of vital nutrients and oxygen.
In ideal situation, during pregnancy, the placenta normally grows in the uterus towards the top of the womb and this leaves the cervix open for delivery. Unfortunately, Grace’s case was different.
Upon discovery, her doctors placed her on bed rest to see if the placenta will revert. While still battling with the problem, she developed placenta abruption, a condition in which the placenta separates from the uterus before childbirth.
At this point, Grace had severe bleeding and her life and that of her baby were threatened. The doctors handling her case became worried. Further medical investigations were conducted on her. In the course of taking her history, it was discovered that Grace was a second-hand smoker. While responding to questions posed by her doctors, Grace confirmed that his husband smoked in the house frequently. Although, Grace was puzzled as to why that should be a factor in her case, the doctors made her to understand that although she was not a smoker, inhaling smoke from a smoker or staying in a smoking environment made her a second-hand smoker and it was dangerous to her and the baby.
Efforts to save her pregnancy proved abortive since there is no surgery or treatment to reattach the placenta. With the development, the baby was no longer getting enough nutrients and oxygen to stay alive in the uterous because studies have shown that placenta is the lifeline structure that forms during pregnancy to provide the foetus with nutrients and oxygen.
Although, immediate medical attention may have helped increase the chance of Grace having a healthy birth despite placenta abruption, she was not lucky. She had preterm birth.
Her baby was born premature at seven months with low birth weight. As if that was not enough trouble for the family, her baby also had congenital heart defects. Today, their baby is one of many children born with various birth defects due to ignorance about the dangers of cigarettes smoking.
Smoking during pregnancy results in more than 1,000 infant deaths annually. Second-hand smoke in adults can lead to coronary heart disease, stroke and lung cancer.
Today, 10 percent of women report that they smoked during the last three months of pregnancy despite available evidence which showed that smoking during pregnancy raises the risk of babies being born with birth defects such as cleft lip and cleft palate as well as Attention Deficit Hyperactivity Disorder (ADHD), one of the most common neuro-behavioral disorders of childhood. About one baby in 10 has the disorder.
It has been established that second-hand smoke causes numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and Sudden Infant Death Syndrome (SIDS).
According to a consultant cardiologist and Head, Paediatric Cardiology Unit, Lagos University Teaching Hospital, LUTH, Professor Christy Okoroma, studies have shown that 35 percent of pregnant smokers risk baby heart defect.
Okoroma explained that congenital heart disease is a major birth defect and the most dangerous because it can kill a child. “For every 1,000 live births, you have 8 to 10 children with congenital defects. The commonest is specifically the one known as hole-in-the-heart. The burden is huge if for every 1000 live births between 8 and 10 are affected, it is a major problem,”the consultant cardiologist said.
“Unfortunately, the heart begins to form early in pregnancy, sometimes even before the mother knows that she is pregnant. You can imagine while the heart is forming and the mother is already consuming alcohol with herbs and other concoctions or inhaling cigarette smoke?”
Lagos State Commissioner for Health, DrJide Idris, during an activity to mark “World No Tobacco Day,” said women comprise 20 percent of the world’s one billion smokers and, in pregnancy, smokers are at higher risk of miscarriages, complications of pregnancy including bleeding during pregnancy, detachments of the placenta, premature birth and etopic pregnancy. “Low birth weight babies, congenital defects and still births are also common occurrences, “he added.
A renowned cardiologist and President, Nigeria Heart Foundation, NHF, Dr. Kingsley Akinroye, also explained that scientific evidence is available that nicotine, contained in cigarette smoke, is a health danger for pregnant woman and ‘developing’ babies in the womb and can damage the babies developing blood vessels, brain and lungs.
“Smoking can negatively affect the development of the placenta, because it could reduce the blood flow to the foetus from the mother; with less delivery of oxygen and nutrient to the foetus. Therefore, the foetus will not be able to grow fully, and develop. Such babies may also develop thickening of the blood vessels (arteries) in adult age with concomitant development of cardiovascular disease,” he stated.
To Akinroye, there are many risks from smoking before and during pregnancy, so it is important that women do not smoke before during and after their reproductive years.
According to the journal PLoS One, nicotine in cigarettes can cause contractions in the fallopian tubes. These contractions can prevent an embryo from passing through. One possible result of this is an ectopic pregnancy. This happens when a fertilized egg implants outside of the uterus, either in the fallopian tube or in the abdomen. In this situation, the embryo must be removed to avoid life-threatening complications to the mother.
Health watchers say for people who are concerned about smoking in pregnancy, the hard truth is that although quitting smoking can be hard, it is one of the best ways a woman can protect herself and her baby’s health.
What you should know about smoking in pregnancy
*Smoking makes it harder for a woman to get pregnant.
Women who smoke during pregnancy are more likely than other women to have a miscarriage.
*Smoking can cause problems with the placenta—the source of the baby’s food and oxygen during pregnancy. For example, the placenta can separate from the womb too early, causing bleeding, which is dangerous to the mother and baby.
*Smoking during pregnancy can cause a baby to be born too early or to have low birth weight.
* Smoking during and after pregnancy is a risk factor for SIDS.
*Babies born to women who smoke are more likely to have certain birth defects, like cleft lip or cleft palate.