Effects of maternal cigarette smoking on placental volume and vascularization measured by 3-dimensional power Doppler ultrasonography at 11+0 to 13+6 weeks of gestation

OBJECTIVE: We sought to establish the effect of maternal smoking on placental volume and vascularization in early gestation. STUDY DESIGN: Three-dimensional power Doppler ultrasonography of the placenta was performed at 11􏰂0 to 13􏰂6 weeks in 80 pregnan- cies categorized according to cigarette consumption: group A never smoked, B smoking 􏰃 10 cigarettes/day, C smoking 10-20 cigarettes/ day, and D smoking 􏰄 20 cigarettes/day. Using a standardized setting, placental volume and vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were calculated. RESULTS: No differences were found in placental volume among groups. In groups C and D lower values were found for VI (group C: t􏰅4.52,P􏰅.0002;groupD:t􏰅3.72,P􏰅.0014),FI(groupC:t􏰅 5.06, P 􏰅 .0001; group D: t 􏰅 4.59, P 􏰅 .0002), and VFI (group C: t 􏰅 3.49, P 􏰅 .0024; group D: t 􏰅 2.88, P 􏰅 .0095). Placental vascu- lar indices were significantly related to birthweight (VI r 􏰅 0.563, FI r 􏰅 0.580, VFI r 􏰅 0.601; P 􏰃 .001). CONCLUSION: Maternal smoking is associated with altered 3-dimen- sional placental Doppler indices and these changes are related to birth weight.