We studied the impact of maternal exposure to environmental tobacco smoke (ETS) on birth weight (BW), low birth weight (LBW), and intrauterine growth retardation (IUGR) according to self-reported maternal smoking habits in a sample of 6,866 singleton births. We obtained data about parental characteristics and maternal active smoking (AS) and passive smoking at delivery via maternal questionnaires and medical records. We used three categories of smoking habits (nonsmokers and those who smoked 1-10 or >10 cigarettes per day) and defined ETS exposure as greater than or equal to 5 cigarettes per day smoked by others in the mother's presence. We used multiple regression and logistic regression procedures with adjustment for many associated covariates. We observed a significant reduction of the mean BW in infants of AS mothers. This reduction was only marginal for mothers who stopped smoking after recognizing their pregnancy. ETS exposure in 1,797 of 5,507 nonsmoking mothers reduced the mean BW of their infants by 53 g [95% confidence interval (CI), 24-82 g]. ETS exposure also significantly reduced BW in babies of AS mothers by 92 g (CI, 21-113 g) compared with BW of ETS-nonexposed AS mothers. The adjusted odds ratio (AOR) of LBW for ETS-exposed AS mothers was two times the LBW risk of ETS-nonexposed AS mothers(2.02; CI, 1.11-3.67); the AOR of ETS-exposed nonsmoking mothers was 1.51 (CI, 1.02-2.26). The AOR of IUGR for this group did not differ from unity (1.08; CI, 0.82-1.43). However, ETS exposure increased the AOR of IUGR for AS mothers from 1.64 (CI, 1.06-2.53) to 2.13 (CI, 1.70-2.67). ETS exposure reduced the BW of infants of nonsmoking mothers and contributed to additional BW reduction in infants of AS mothers. ETS exposure increased the risk of LBW but not that of IUGR in babies of nonsmoking mothers.

Vitamin C, E and A levels in maternal and cord blood sera were examined at delivery in two districts of the Czech Republic. Information on personal and social characteristics, health, ethnicity, and lifestyle was also collected. A highly significant correlation between ascorbate levels in maternal and cord blood was found. Vitamin C levels in cord blood were about 1.7 times those in maternal blood. This ratio was much higher for mothers deficient in vitamin C: it was about 3 for deficient nonsmokers and as high as 5 for deficient mothers who smoked cigarettes (p < 0.01). This finding may suggest a compensatory mechanism in fetuses that are endangered by oxidative stress. The mean maternal blood levels of vitamin A and E were higher than in fetal blood (both p < 0.001). The mean fetal/maternal ratios were 0.7 for vitamin A and 0.2 for vitamin E levels; these ratios were considerably higher for mothers deficient in a particular vitamin as compared with those for well-nourished mothers. Ascorbate levels were associated with maternal education and smoking. Significantly decreased vitamin C levels were observed in Gypsy mothers and their babies; this may be attributed to unfavorable diet and smoking habits: about 78% of Gypsy mothers admitted smoking as compared with 31% of Czech mothers.

The single cell gel electrophoresis assay (Comet assay) was selected as a biomarker of exposure to evaluate the impact of air pollution and lifestyle variables on hospitalized pregnancies in two districts with different air pollution levels in northern (Teplice) and southern (Prachatice) Bohemia. The hypothesis was that the DNA damage detected as single strand breaks would be generally higher in the district with higher air pollution levels. To undertake the study we enrolled 322 pregnancies in Teplice and 220 in Prachatice. Venous and cord blood were analysed using the original alkaline Comet assay procedure with lysis for 60 min, unwinding for 40 min and electrophoresis for 24 min. We also used a modified procedure in which unwinding was prolonged to 60 min and electrophoresis to 40 min. Peripheral white blood cells (WBC) were analysed using an image analyser system. When we analysed the results obtained for mothers and their children no differences were found between polluted and control districts. The prolongation of alkali unwinding and electrophoresis did not increase sensitivity of the assay. No effects of prematurity, ethnicity, smoking or GSTM1 polymorphism were observed for any of the Comet parameters. Multiple regression analyses were performed for the European population (n = 285). A statistical model was fitted to determine the relationship between the Comet parameters of mothers and their children. According to our results it seems that the Comet assay was not a particularly sensitive technique to determine the effects of environmental pollution at the DNA level if peripheral WBC are used.

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