Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study
| dc.contributor.author | Jonker, Deborah | |
| dc.contributor.author | Melly, Brigitte | |
| dc.contributor.author | Brink, Lucy T. | |
| dc.contributor.author | Odendaal, Hein J. | |
| dc.contributor.author | Stein, Dan J. | |
| dc.contributor.author | Donald, Kirsten A. | |
| dc.date.accessioned | 2023-09-19T09:04:54Z | |
| dc.date.available | 2023-09-19T09:04:54Z | |
| dc.date.issued | 2023-08-23 | |
| dc.date.updated | 2023-08-27T03:11:18Z | |
| dc.description.abstract | Background The negative impact of prenatal alcohol and tobacco exposure (PAE and PTE) on fetal development and birth outcomes are well described, yet pathophysiologic mechanisms are less clear. Our aim was to investigate (1) the associations between quantity, frequency and timing (QFT) of PAE and PTE with blood flow velocities in arteries of the fetal-placental-maternal circulation and (2) the extent to which combined effect of QFT of PAE and/or PTE and Doppler flow velocity waveforms (FWV) predict infant birth weight. Methods The Safe Passage Study is a cohort based in urban Cape Town, South Africa. Recruitment occurred between 2007 and 2015. Information on QFT of PAE and PTE was collected prospectively at up to 4 occasions during pregnancy using a modified Timeline Follow-Back approach. Ultrasound examinations consisted of Doppler flow velocity waveforms of the uterine, umbilical (UA) and fetal middle cerebral arteries for the pulsatility index (PI) at 20–24 and 34–38 weeks. Exclusion criteria included: twin pregnancies, stillbirths, participants exposed to other drugs. The sample was divided into three groups (controls, PAE and PTE) and included 1396 maternal-fetal-dyads assessed during the second trimester; 1398 assessed during the third trimester. Results PTE was associated with higher UA PI values in second and third trimesters (p < 0.001), compared to the PAE and control group. The total amount of cigarettes smoked during pregnancy was positively correlated with UA PI values (r = 0.087, p < 0.001). There was a positive correlation between cigarettes smoked per day in trimester one (r = 0.091, p < 0.01), and trimester two (r = 0.075, p < 0.01) and UA PI (in trimester two), as well as cigarettes smoked per day in trimester two (r = 0.058, p < 0.05) and trimester three (r = 0.069, p < 0.05) and the UA PI in trimester three. Generalized additive models indicated that PAE in trimester two, PTE in trimester one and Doppler FWV in trimester three were significant predictors of birth weight in this sample. Conclusion In our study, PTE in trimesters two and three resulted in increased vascular resistance of the placenta. These findings highlight nuance in associations between PAE, PTE and blood flow velocities in arteries of the fetal-placental-maternal circulation and birth weight, suggesting that quantity and timing are important factors in these relationships. | |
| dc.identifier.apacitation | Jonker, D., Melly, B., Brink, Lucy T., Odendaal, Hein J., Stein, Dan J., & Donald, Kirsten A. (2023). Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study. <i>BMC Pregnancy and Childbirth</i>, 23(1), 601. http://hdl.handle.net/11427/38766 | en_ZA |
| dc.identifier.chicagocitation | Jonker, Deborah, Brigitte Melly, Lucy T. Brink, Hein J. Odendaal, Dan J. Stein, and Kirsten A. Donald "Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study." <i>BMC Pregnancy and Childbirth</i> 23, 1. (2023): 601. http://hdl.handle.net/11427/38766 | en_ZA |
| dc.identifier.citation | Jonker, D., Melly, B., Brink, Lucy T., Odendaal, Hein J., Stein, Dan J. & Donald, Kirsten A. 2023. Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study. <i>BMC Pregnancy and Childbirth.</i> 23(1):601. http://hdl.handle.net/11427/38766 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Jonker, Deborah AU - Melly, Brigitte AU - Brink, Lucy T. AU - Odendaal, Hein J. AU - Stein, Dan J. AU - Donald, Kirsten A. AB - Background The negative impact of prenatal alcohol and tobacco exposure (PAE and PTE) on fetal development and birth outcomes are well described, yet pathophysiologic mechanisms are less clear. Our aim was to investigate (1) the associations between quantity, frequency and timing (QFT) of PAE and PTE with blood flow velocities in arteries of the fetal-placental-maternal circulation and (2) the extent to which combined effect of QFT of PAE and/or PTE and Doppler flow velocity waveforms (FWV) predict infant birth weight. Methods The Safe Passage Study is a cohort based in urban Cape Town, South Africa. Recruitment occurred between 2007 and 2015. Information on QFT of PAE and PTE was collected prospectively at up to 4 occasions during pregnancy using a modified Timeline Follow-Back approach. Ultrasound examinations consisted of Doppler flow velocity waveforms of the uterine, umbilical (UA) and fetal middle cerebral arteries for the pulsatility index (PI) at 20–24 and 34–38 weeks. Exclusion criteria included: twin pregnancies, stillbirths, participants exposed to other drugs. The sample was divided into three groups (controls, PAE and PTE) and included 1396 maternal-fetal-dyads assessed during the second trimester; 1398 assessed during the third trimester. Results PTE was associated with higher UA PI values in second and third trimesters (p < 0.001), compared to the PAE and control group. The total amount of cigarettes smoked during pregnancy was positively correlated with UA PI values (r = 0.087, p < 0.001). There was a positive correlation between cigarettes smoked per day in trimester one (r = 0.091, p < 0.01), and trimester two (r = 0.075, p < 0.01) and UA PI (in trimester two), as well as cigarettes smoked per day in trimester two (r = 0.058, p < 0.05) and trimester three (r = 0.069, p < 0.05) and the UA PI in trimester three. Generalized additive models indicated that PAE in trimester two, PTE in trimester one and Doppler FWV in trimester three were significant predictors of birth weight in this sample. Conclusion In our study, PTE in trimesters two and three resulted in increased vascular resistance of the placenta. These findings highlight nuance in associations between PAE, PTE and blood flow velocities in arteries of the fetal-placental-maternal circulation and birth weight, suggesting that quantity and timing are important factors in these relationships. DA - 2023-08-23 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Pregnancy and Childbirth KW - Blood flow KW - Doppler ultrasound KW - Umbilical artery KW - Uterine artery KW - Middle cerebral artery KW - Prenatal alcohol exposure KW - Prenatal tobacco exposure KW - Birth weight LK - https://open.uct.ac.za PY - 2023 T1 - Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study TI - Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study UR - http://hdl.handle.net/11427/38766 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12884-023-05881-2 | |
| dc.identifier.uri | http://hdl.handle.net/11427/38766 | |
| dc.identifier.vancouvercitation | Jonker D, Melly B, Brink Lucy T, Odendaal Hein J, Stein Dan J, Donald Kirsten A. Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study. BMC Pregnancy and Childbirth. 2023;23(1):601. http://hdl.handle.net/11427/38766. | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Paediatrics and Child Health | |
| dc.publisher.faculty | Health Sciences | |
| dc.rights.holder | BioMed Central Ltd., part of Springer Nature | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
| dc.source | BMC Pregnancy and Childbirth | |
| dc.source.journalissue | 1 | |
| dc.source.journalvolume | 23 | |
| dc.source.pagination | 601 | |
| dc.source.uri | https://bmcpregnancychildbirth.biomedcentral.com/ | |
| dc.subject | Blood flow | |
| dc.subject | Doppler ultrasound | |
| dc.subject | Umbilical artery | |
| dc.subject | Uterine artery | |
| dc.subject | Middle cerebral artery | |
| dc.subject | Prenatal alcohol exposure | |
| dc.subject | Prenatal tobacco exposure | |
| dc.subject | Birth weight | |
| dc.title | Associations between prenatal alcohol and tobacco exposure on Doppler flow velocity waveforms in pregnancy: a South African study | |
| dc.type | Journal Article |