Lipoprotein pattern in umbilical cord blood of neonates of smoking and non smoking mothers.

Abstract

Assmussen recently reported in several publications (1-5) on morphological alterations in the vessels of the umbilical cords and the placentae of neonates whose mothers had smoked cigarettes during pregnancy. They interpreted their findings as a prodromal form of arteriosclerotic changes in the vascular endothelium. The hyperlipoproteinemias are wellknown risk factors for arteriosclerotic cardiovascular diseases in adults as well as in childhood. It is established that there is a negative correlation between high density lipoprotein cholesterol concentration in the serum (HDL cholesterol) and arteriosclerosis. The low density lipoprotein and the very low density lipoprotein cholesterol (LDL and VLDL cholesterol) show a positive relationship with the vascular diseases. Studies on the influence of cigarette smoking on cholesterol metabolism show that the concentration of HDL cholesterol in the serum is lower than in nonsmokers (6, 7 ) . The lowering of HDL cholesterol can last up to one year after final abstinence ( 6 , 7 ) . Since the unborn child of a smoker is exposed to cigarette smoke for nine months, it appears possible that a shift of the LDL-HDL quotient might occur in the neonate. In the present study the umbilical cord blood from 78 neonates was investigated. Women under 18 and over 35 years of age, women with a severe varicosis, cardiovascular diseases, hypertension, metabolic diseases including disorders of lipid metabolism, with medication, drug, coffee and alcohol abuse as well as pregnant women with a cervical insufficiency or therapeutic cerclage and toxemia of pregnancy were excluded from the study. Further exclusion criteria were a pre-, intraor postnatal asphyxia of the child, pathological labor, abnormal presentation of the newborn, pathological Apgar score and shortened duration of pregnancy. The age, weight, height, number of earlier miscarriages, stillbirths and live births, duration of pregnancy and social status were comparable between controls and the smoker group. The interview with regard to smoking habits was carried out with a standardized questionnaire. A total of four groups were formed: Group 1 (n=23). Nonsmokers; control group with women who had smoked neither before (at least two years) nor during pregnan-