Ett av världens största dolda problem

Personligen tror jag det är klokt av blivande och nyblivna mammor att vara försiktiga, inte minst med sjukvårdens egna produkter, och tandvårdens diton ska vi bara inte tala om. Skulle tro att det är betydligt mer riskfyllt för en blivande mamma att gå till tandläkaren och borra i och i laga en trasig gammal amalgamfyllning (består till 50 procent av kvicksilver) än att röra sig en stund ute i trafikmyllret i Stockholm. Men det är ju bara som jag tror. Går man till fakta rörande graviditet och rökning framträder en annan bild där det ständiga tjatatet om tobaksrökning framstår som  både tröttsamt och tveksamt:

Naeye: “We recently found no significant association between maternal smoking
and either stillbirths or neonatal deaths when information about the underlying disorders,
obtained from placental examinations, was incorporated into the analysis. Similar analyses
found no correlation between maternal smoking and preterm birth. The most frequent
initiating causes of preterm birth, stillbirth, and neonatal death are acute
chorioamnionitis, disorders that produce chronic low blood flow from the uterus to the
placenta, and major congenital malformations. There is no credible evidence that cigarette
smoking has a role in the genesis of any of these disorders.” Naeye’s study
population is the 56,000+ pregnancies of the Collaborative Perinatal Study. (RL Naeye. Disorders
of the placenta, fetus, and neonate, diagnosis and clinical significance. New
York: CV Mosby Co., 1992).

Och:

“Acute chorioamnionitis is the largest contributor to the poor pregnancy
outcomes of black women and women who have low socioeconomic status,” and it is “the
most common cause of preterm labor wherever it has been studied.” (RL Naeye. Acute
chorioamnionitis and the disorders that produce placental insufficiency. In:
Monographs in Pathology No.33, Pathology of Reproductive Failure. FT Kraus et al, eds.
Williams and Wilkins 1991. Ch 10, pp 286-307).

Och:

Smokers’ lower average socioeconomic status results in serious confounding, because
chorioamnionitis is the most commonly missed perinatal diagnosis. Only 1/10 of affected
mothers show symptoms, and only 1/4 of fatal cases could be diagnosed without
histopathological analysis. (RL Naeye. Editorial. The investigation of perinatal deaths.
NEJM  1983;309(10):611-612).

Och så vidare.