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de la Chica RA, Ribas I, Giraldo J, Egozcue J, Fuster C. Chromosomal Instability in Amniocytes From Fetuses of Mothers Who Smoke. JAMA. 2005;293(10):1212–1222. doi:10.1001/jama.293.10.1212
Author Affiliations: Departament de Biologia
Cel·lular, Fisiologia i Immunologia, Facultat de Medicina, Universitat
Autònoma de Barcelona, Bellaterra, Spain (Ms de la Chica and Drs Egozcue
and Fuster); Centro de Patología Celular, Barcelona, Spain (Dr Ribas);
and Unitat de Bioestadística, Facultat de Medicina, Universitat Autònoma
de Barcelona, Bellaterra (Dr Giraldo).
Context Tobacco increases the risk of systemic diseases, and it has adverse
effects on pregnancy. However, only indirect data have been published on a
possible genotoxic effect on pregnancy in humans.
Objectives To determine whether maternal smoking has a genotoxic effect on amniotic
cells, expressed as an increased chromosomal instability, and to analyze whether
any chromosomal regions are especially affected by exposure to tobacco.
Design, Setting, and Patients In this prospective study, amniocytes were obtained by routine amniocentesis
for prenatal diagnosis from 25 controls and 25 women who smoke (≥10 cigarettes/d
for ≥10 years), who were asked to fill out a smoking questionnaire concerning
their smoking habits. Chromosomal instability was analyzed in blinded fashion
by 2 independent observers in routine chromosome spreads. Breakpoints implicated
in chromosomal abnormalities were identified by G-banding.
Main Outcome Measures Association between maternal smoking and increased chromosomal instability
in amniotic fluid cells, expressed as chromosomal lesions (gaps and breaks)
and structural chromosomal abnormalities.
Results Comparison of cytogenetic data between smokers and nonsmokers (controls)
showed important differences for the proportion of structural chromosomal
abnormalities (smokers: 12.1% [96/793]; controls: 3.5% [26/752]; P = .002)
and to a lesser degree for the proportion of metaphases with chromosomal instability
(smokers: 10.5% [262/2492]; controls: 8.0% [210/2637]; P = .04),
and for the proportion of chromosomal lesions (smokers: 15.7% [391/2492];
controls: 10.1% [267/2637]; P = .045). Statistical
analysis of the 689 breakpoints detected showed that band 11q23, which is
a band commonly implicated in hematopoietic malignancies, was the chromosomal
region most affected by tobacco.
Conclusions Our findings show that smoking 10 or more cigarettes per day for at
least 10 years and during pregnancy is associated with increased chromosomal
instability in amniocytes. Band 11q23, known to be involved in leukemogenesis,
seems especially sensitive to genotoxic compounds contained in tobacco.
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