Seeing Babies In Utero May Help Pregnant Smokers Quit

Seeing is believing.

This is one of the key strategies being used by researchers at The University of Texas Medical School at Houston, who are testing whether women will find it easier to quit smoking when exposed to ultrasound images of their babies in utero. The four-year study, funded with a $944,000 Robert Wood Johnson grant, is being conducted by Janet Groff, M.D., assistant professor and research director in the department of family practice and community medicine, and her colleagues, co-investigators Angela Stotts, Ph.D., department of psychiatry and behavioral sciences; Joan Mastrobattista, M.D., department of obstetrics and gynecology; and Mary Velasquez, Ph.D., department of family practice and community medicine.

The 360 women taking part in this study are in the second trimester of pregnancy and assigned to one of three groups: ultrasound plus counseling, ultrasound plus enhanced counseling, or counseling only.

To take part in the study, women must have smoked within the past seven days, be between 15 and 26 weeks pregnant, and at least 16 years of age. Through ultrasound intervention, these pregnant smokers are given a chance for better health, not only for themselves, but for the young lives they carry.

Obstetrical-gynecological ultrasound sonographers play a key role in their interactions with the smokers.

“These professionals have potentially the greatest impact on the woman during the ultrasound process,” Groff said, adding that they are uniquely situated to impart both visual and verbal cues concerning the baby’s medical condition.

Since low birth weight is a confirmed result of pregnant smokers, ultrasound technicians show the woman pictures of her baby in utero, starting out at the placenta, and proceeding to the umbilical cord, body parts, head, heart, and genitalia. They make sure the due date is correct and ultimately show the woman how smoking can harm her baby.

Introduced in the late 1950s, ultrasounds have become commonplace in obstetrics, and have proven to be safe, noninvasive, accurate, and cost effective. A real-time scanner, the ultrasound captures a picture of a moving fetus as seen on a monitor screen. To do this, very high frequency sound waves are emitted from a transducer and placed in contact with the woman’s abdomen. Ultrasound beams scan the fetus and are recomposed back into a picture on the monitor. Measurements can then be taken to assess the age, size, and growth of the fetus.

In addition to the ultrasound scan, the pregnant smokers have saliva samples taken to test for nicotine and receive counseling about smoking cessation. Participants also are given five points to ponder:

• Cigarette smoke does damage by decreasing blood flow to a baby.
• Smoking increases carbon monoxide in a baby’s blood.
• By decreasing oxygen and nourishment, smoking increases the likelihood of a baby being born too small and too early.
• Smoking can cause the mother’s water to break too early.
• There is an increased chance of the placenta separating from the uterus before a baby is born, causing severe bleeding – a life-threatening situation for both mother and child.

Three years from now, the success rate of this initial study will be known. The goal is to get at least 20 percent of the participants to quit, and already one life has been changed. The group recently celebrated when a former smoker walked in and said that despite smoking for 20 years, as a result of the study she would never smoke again.

“The bottom line is that women who smoke, while concerned about their health, still care desperately about their babies,” Groff said “They don’t quit for themselves. If they’re going to quit, they’ll quit for the baby.”

For more information about the study, call (713) 500-7593, or 1-877-YES-QUIT (937-7848).

---

©2006 Texas Medical Center

---

E-Mail: tmcinfo@texmedctr.tmc.edu
URL: http://www.tmc.edu/tmcnews/10_15_02/page_12.html