Smoking While Pregnant: Transplacental Mutagenesis of the Fetus by Tobacco Smoke

摘要

The International Agency for Research on Cancer(IARC) has identified tobacco smoking as the cause of cancer at more organ sites (11) than any other human carcinogen. Eight of these organ sites have been examined for smoking-associated genotoxic effects, and such effects have been found in all 8 sites. The sites are the oralasal cavity, esophagus, pharynx/larynx, lung, pancreas, myeloid organs, bladder/ureter, and uterine cervix. To this long list of organs in adults in which tobacco smoking causes genotoxic effects might now be added the somatic epithelial cells of fetuses carried by mothers who smoke. As described by de la Chica and colleagues in this issue of JAMA, smoking during pregnancy was reported to be associated with increased chromosomal instability in amniocytes collected by amniocentesis. Such results, if substantiated, would provide direct evidence of tobacco-associated intrauterine mutagenesis and could have important implications for the immediate and long-term health effects of children born to mothers who smoke.