Smoking during pregnancy and placental pathology.

The pathological study of all placentas from women smoking at least five cigarettes daily during pregnancy (248 cases) and of those placentas from a corresponding control group randomised among all the non-smokers (196 cases) has been set up at the maternity hospital of Haguenau (France) since 1974. The systematic histological examination has shown among smokers a higher frequency of abonormal trophoblast and especially of nuclear clumps in the syncytiotrophoblast. On the other hand, according to a standard protocol, the grouping of various abnormalities has shown, among smokers, a higher frequency of "signs of hypoxia". The lack of relationship between these "signs of hypoxia" and the well-known decreased birthweight among smokers suggests that smoking during pregnancy could always go with a decreased birthweight without a corresponding decreased placental weight, and seldom with an intra-uterine hypoxia. These two effects are independent.