Maternal smoking disrupts fetal and neonatal calcium metabolism

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Maternal smoking is associated with a modest fetal growth restriction and altered lung development. Díaz-Gómez et al show that maternal smoking is associated with decreased parathyroid hormone (PTH) and increased phosphorus, a result consistent with other reports for smokers in general. The maternal smoking resulted in newborns with lower PTH levels, higher phosphorus, and lower serum 25 hydroxyvitamine D levels. These results demonstrate a relative hypoparathyroidism in both mother and fetus/newborn. The fetus is utilizing large amounts of transplacental calcium to grow and ossify bones during late gestation. Any disruption in bone ossification will be reflected in decreased bone density, and it may be difficult for the newborn to “catch up”. The effects of post delivery exposure to smoking on calcium metabolism are unknown.