Vitamin C and Pregnant Women Who Smoke

Improving pulmonary function in newborns.

500 mg of daily vitamin C given to pregnant smoking women “decreased the effects of in-utero nicotine” and “improved measures of pulmonary function” in their newborns, according to a study  by Cindy T. McEvoy and others at the Oregon Health and Science University in Portland, published in a recent issue of the Journal of the American Medical Association (JAMA).

Researchers have long known that smoking during pregnancy can harm the respiratory health of newborns. Maternal smoking during pregnancy can interfere with normal lung development, resulting in lifelong increases in asthma risk and other pulmonary complications. The researchers note that “more than 50% of smokers who become pregnant continue to smoke, corresponding to 12% of all pregnancies.” That adds up to a lot of newborns each year who will start off with more wheezing, respiratory infections, and childhood asthma than their counterparts born to non-smoking mothers.

McEvoy and her colleagues wanted to find out whether a daily dose of vitamin C would improve the results of pulmonary function tests in newborns exposed to tobacco in utero.

It did. In an accompanying editorial, Graham L. Hall calls the randomized, double-blind, placebo-controlled clinical trial “well-conceived and executed…. Lung function during the first week of life was statistically significantly better (by approximately 10%) among infants born to mothers randomized to receive Vitamin C compared with infants born to mothers randomized to received placebo.” Moreover, the prevalence of wheezing in the first year was reduced from 40% in the placebo group to 21% in the Vitamin C group.

The decreases in asthma and wheezing in the Vitamin C newborns were documented through the first year of life. 

A 10% reduction does not sound like a lot, but, as Hall writes, “small population-level changes in lung function may lead to significant public health benefits, and the improvements in lung function reported here could be associated with future benefit.”

In their paper, the researchers conclude: “Vitamin C supplementation in pregnant smokers may be an inexpensive and simple approach (with continued smoking cessation counseling) to decrease some of the effects of smoking in pregnancy on newborn pulmonary function and ultimately infant respiratory morbidities, but further study is required.”

Pregnant women should not smoke, and quitting is by far the healthiest option.  As Hall writes: “By preventing her developing fetus and newborn infant from becoming exposed to tobacco smoke, a pregnant woman can do more for the respiratory health and overall health of her child than any amount of vitamin C may be able to accomplish.”

McEvoy C.T.,  Nakia Clay,  Keith Jackson,  Mitzi D. Go,  Patricia Spitale,  Carol Bunten,  Maria Leiva,  David Gonzales,  Julie Hollister-Smith &  Manuel Durand &  (2014). Vitamin C Supplementation for Pregnant Smoking Women and Pulmonary Function in Their Newborn Infants, JAMA, 311 (20) 2074. DOI: http://dx.doi.org/10.1001/jama.2014.5217

Graphics Credit: http://www.quitguide.com/

Women, Cigarettes, and Meth

More bad news for young female addicts.

A blizzard of research findings this year continues to demonstrate that women have gender-specific issues to deal with when it comes to cigarettes and speed. None of the findings have anything to do with the old canard that women cannot “hold their liquor,” or do drugs like men do. Women hold their liquor fine, on a pound for pound basis. And women are well represented, presently, among the ranks of alcoholics. That is unfortunate, since a great deal of research has shown that alcohol causes neurological damage in women more quickly than in men. And now comes more evidence that women don’t respond metabolically to cigarettes and speed the same as men, either.

Start with cigarettes: Women who begin smoking have a great risk of heart attack than men who take up the addiction—but scientists don’t know exactly why. Cardiovascular diseases remain the leading cause of female deaths in the developed world. One theory is that smoking lowers levels of “good” cholesterol more markedly in women than in men. This is not news, but preliminary research in the Journal of Clinical Endocrinology and Metabolism now appears to show that teenaged girls in Australia were more sensitive to the effects of second-hand smoke than teenaged boys. If true, it could mean that “childhood passive smoke exposure may be a more significant cardiovascular risk factor for women than men,” lead author Chi Le-Ha said in a press release. 

And there’s more bad news: Research published in Diabetologia, the journal of the European Association for the Study of Diabetes, suggests that women who continue to smoke during pregnancy increase the risk for obesity and diabetes in their unborn daughters. Kristin Mattsson of Lund University in Sweden, along with Matthew Longnecker and members of the National Institute on Environmental Health Sciences in North Carolina, reported that data from the Medical Birth Register of Sweden showed that the risk (odds ratio) of gestational diabetes increased 52-62 per cent for women exposed to moderate or heavy smoking while in the womb. After adjusting the data for a host of outside factors, the researchers also concluded that women exposed to moderate amounts of smoking while in the womb were 36 per cent more likely to become obese, while the daughters of heavy smokers during pregnancy were 58 per cent more likely to be obese compared to non-smokers in the study.

Again, researchers are not quite sure what accounts for this effect. The researchers suggest a variety of possible answers: Alterations in appetite regulation, death of insulin-producing cells in the pancreas, gene transcription changes causing the formation of fat cells, and epigenetic changes. But it may be that other factors—undetected differences in nutrition, extent of prenatal care, neglect, abuse, and many other variables—make it difficult to determine the major difference in outcomes between smoking and non-smoking families. Nailing down these risk factors becomes all the more important as young women in countries all around the world take up daily smoking in greater numbers than ever. The authors emphasize the importance of recognizing such long-term detrimental effects on offspring.

As for methamphetamine: A study in the Journal of Adolescent Health, conducted by the UCLA Center for Behavioral and Addiction Medicine, followed a group of adolescents in treatment for methamphetamine addiction. They found that girls were more likely to continue using meth during treatment than boys. Overall, boys returned twice as many meth-free urine samples as the girls in the program. Lead author Keith Heinzerling said in a prepared statement that the findings may have significant implications for treatment: “The greater severity of methamphetamine problems in adolescent girls compared to boys, combined with results of studies in adults that also found women to be more susceptible to methamphetamine than men, suggests that the gender differences in methamphetamine addiction observed in adults may actually begin in adolescence.” The small NIDA-funded study, involving only 19 teenagers, also found that the antidepressant Wellbutrin, used effectively in many smoking cessation programs, was not effective in curbing use among the teen meth addicts.