Fetal tobacco syndrome is caused by active, as well as passive, smoking during pregnancy, as the approximately 5000 different toxins from a burning cigarette also reach the fetus through the placenta. Miscarriages and premature births are just as often associated with fetal tobacco syndrome, as are sudden infant death syndrome or general developmental disability, low IQ, asthma and other respiratory disorders in the newborn child.
What is fetal tobacco syndrome?
Fetal tobacco syndrome is the medical term for the totality of diseases and phenomena from which an unborn child may suffer as a result of active and passive tobacco use during pregnancy. Smokers inhale up to 5000 different chemicals. For this reason, doctors advise against smoking not only in general, but especially during pregnancy, since the unborn child smokes along with the mother. Even if there is no active tobacco use, the fetus can suffer from fetal tobacco syndrome, for example in the case of mothers who smoke passively and whose spouse reaches for a cigarette in the home. Fetal tobacco syndrome can also have severe consequences after the child is born. Sudden infant death syndrome, for example, is associated with passive smoking in half of all cases. More common, however, are developmental disorders that can manifest themselves after birth in low IQ, low weight, growth disorders, asthma, or allergic disorders.
Causes
As the name implies, active and passive tobacco use by the expectant mother is the cause of fetal tobacco syndrome. Tobacco toxins such as arsenic, hydrogen cyanide, benzene, cadium, or lead, as well as carbon monoxide and tar, are passed through the placenta to the embryo. The placenta is not equipped with filter mechanisms and therefore cannot distinguish which substances the fetus needs and which should rather be kept away from it. Depending on the intensity of tobacco consumption, the unborn child can thus suffer considerable damage while still in the womb and may even abort. The developmental stages of the fetus are also negatively affected by tobacco, which is often causal for low birth weight.
Symptoms, complaints and signs
There is no blanket way to predict which symptoms and complaints are associated with fetal tobacco syndrome. A whole range of different, health consequences may be associated with tobacco use during pregnancy. For example, newborns often have poorer lung function than children born to non-smoking parents. Infections, particularly those of the respiratory tract and middle ear, may also be favored by parental cigarette use. Equally common are obesity, diabetes, and cardiovascular disease associated with fetal tobacco syndrome. In addition, early childhood development may be delayed or otherwise impaired as a consequence of the syndrome. In connection with deformities, the so-called cleft lip is particularly common in various degrees. In general, there is talk of poorer health consitution in connection with fetal tobacco syndrome in newborns than in newborns of nonsmoking parents.
Diagnosis and course
The diagnosis of fetal tobacco syndrome is made primarily on the basis of the history. However, because many different and relatively nonspecific early childhood conditions may be associated with the syndrome, a definite diagnosis is almost impossible. Still during pregnancy, the fetal tobacco syndrome often manifests itself in placental abruption, resulting in miscarriage in the worst case or premature birth in the best possible case. The later course of the syndrome depends largely on the symptoms in which past tobacco use manifests itself. In the worst case, sudden infant death syndrome may occur. More often, general developmental disorders or a general decline in health occur, which may manifest throughout the child’s life.
Complications
A wide range of health complications are associated with fetal tobacco syndrome. While still pregnant, there is an increased risk of premature placental dissolution and, subsequently, premature birth or miscarriage. After birth, the syndrome often leads to general developmental disorders and a general decline in the health of the child. In the worst case, sudden infant death syndrome occurs.The health problems can manifest themselves throughout life. Typical late effects include behavioral problems, poor concentration and hyperactivity. In addition, the risk of cancer or cardiovascular disease is greatly increased in children with fetal tobacco syndrome. Affected newborns often have reduced lung function and suffer from asthma and other respiratory diseases later in life. They are also at increased risk of obesity and, consequently, type 2 diabetes mellitus. Many sufferers develop malignant blood and lymph gland disorders, which place an even greater strain on an already battered organism. Externally, the disease can lead to the formation of clubfeet, eye deformities and hernias. In rare cases, the heart is also reduced in size or otherwise damaged as a result of the syndrome.
When should you see a doctor?
There is no direct treatment available from a doctor for this syndrome. In this case, the affected person must overcome their addiction and not smoke cigarettes during pregnancy in order not to endanger the well-being of the child. However, if quitting cigarettes does not work without outside help, withdrawal can be performed. This can prevent many complications and discomforts in the child. Psychological support and treatment can also be very advisable. Furthermore, visits to the doctor are also necessary in this syndrome if the child suffers from various deformities due to tobacco use. These should be diagnosed and treated at a very early stage. Especially complaints about the ears or the heart can occur and complicate the patient’s everyday life. The syndrome itself can be diagnosed by a general practitioner or by a pediatrician. Further treatment, however, is carried out by the respective specialists and is highly dependent on the severity of the symptoms. However, if smoking is stopped early, most of the symptoms can be limited. This also significantly increases the life expectancy of the child.
Treatment and therapy
The physician decides on an appropriate treatment depending on the symptoms present. Since the past tobacco use is the cause of the fetal tobacco syndrome, in a narrower sense, causal treatment can no longer be given, but only symptomatic treatment. Malformations such as cleft lip can be corrected by surgical intervention. Special drugs are available for the treatment of respiratory diseases. The same applies to diabetes and many cardiovascular diseases. However, the general developmental disorders of affected children can hardly be resolved.
Outlook and prognosis
The health damage associated with fetal tobacco syndrome is not considered curable. In many cases, the expectant mother’s tobacco use triggers permanent health impairments in the child’s development and growth process during pregnancy. General developmental disorders, short stature or mental reduction must be individually tested and diagnosed after birth. The prognosis of fetal tobacco syndrome is therefore largely dependent on the very different consequential damage caused by the pregnant woman’s active or passive tobacco use. In severe cases, sudden infant death syndrome occurs. Surviving children often suffer from the effects of tobacco syndrome for the rest of their lives. The child’s quality of life is affected by allergies, respiratory diseases, mental abnormality or low body weight. If targeted support measures are taken immediately after birth, long-term improvements in well-being can be achieved. Selected therapies or early medical care will support and stabilize the child’s immune system. If the environmental conditions are adapted to the needs of the child, cognitive improvements as well as health optimizations can be achieved. Adults are normally able to manage their lives independently. Nevertheless, they have an increased risk of suffering from secondary diseases such as asthma, cancer or mental disorders.
Prevention
Fetal tobacco syndrome can be prevented. In this context, pregnant women should, for example, stop smoking. If this is not possible for them, a drastic reduction in tobacco consumption to a maximum of five cigarettes a day is considered the minimum requirement.However, since passive tobacco consumption can also trigger fetal tobacco syndrome, expectant mothers should also refrain from spending time in smoky rooms. If their partner is a smoker, for example, he or she should leave the apartment to smoke. Of course, parents must also always keep an infant away from tobacco smoke. Although in this context there is no longer any question of fetal tobacco syndrome, cigarette smoke could still trigger sudden infant death syndrome or respiratory illnesses even if the child comes into contact with it only in the first few weeks after birth.
Follow-up
In most cases of this disease, the measures or possibilities of aftercare are very limited, so tobacco syndrome must be prevented in the first place. During pregnancy, smoking must therefore be avoided in any case, so that malformations or other defects do not occur in the child. The aftercare itself depends very much on the exact nature and extent of the defects and malformations, so that no general prediction can be made. In most cases, the children are dependent on the help of the family or relatives in tobacco syndrome to cope with everyday life. Loving care and support always have a positive effect on the further course of the disease. It is not uncommon for psychological upsets to have to be treated, and discussions with friends and family can also be helpful. Intensive measures are necessary to promote the development of the child, whereby many exercises can also be carried out at home. Above all, the parents must become active in order to alleviate the symptoms of the tobacco syndrome. Possibly the life expectancy of the child is limited by the tobacco syndrome.
This is what you can do yourself
The best form of self-help for fetal tobacco syndrome is consistent prevention. The syndrome is caused exclusively by regular smoking or passive smoking during pregnancy. Smokers should therefore be clear before pregnancy whether they can and want to give up tobacco consumption for nine months. Nicotine withdrawal should be started before the woman concerned tries to become pregnant. Those who cannot give up smoking without help should seek support for this. On the one hand, there are self-help groups on the Internet that encourage and support those affected and help to ensure that they do not lose motivation. In addition, there are special chewing gums and dragées from pharmacies that make withdrawal easier. Those affected should seek advice here from a pharmacist. Since passive smoking is also enormously harmful to the embryo, it is important that there is no more smoking in the pregnant woman’s entire social environment. The partner, if he or she consumes nicotine, must also give up smoking or consistently leave the shared apartment and car while smoking. A smoke-free environment should also be maintained in the workplace. Employers are required to protect nonsmokers from the effects of secondhand smoke. If there are gaps in this respect at the workplace, the works council or the trade union should be called in. As a rule, there is also a violation of the Workplace Ordinance, so that the trade supervisory authority can intervene.
