569: Smoking cessation in pregnancy: impact on the bio-inflammatory milieu

Maternal tobacco use is associated with a pro-inflammatory state. This study was undertaken to evaluate the impact of smoking cessation during pregnancy on alterations in inflammatory biomarkers. This was a secondary analysis of a prospective, longitudinal multicenter study of women with a singleton gestation. We identified a cohort who reported tobacco use at the 1st trimester and followed their tobacco use patterns to identify patients who continued smoking, and those who had quit during pregnancy. Maternal serum was collected in each trimester. Cytokines (IL-1a, IL-1b, IL-2, IL-6, IL-8, IL-10, TNF-α, CRP and MMP-8) were measured using multiplex beadlyte assay on a Luminex IS-100. At each time point smoking status was validated by preset urine cotinine levels. Univariate and multivariate regression analyses were performed evaluating differences in cytokine levels as well as the change in cytokine levels across pregnancy, between study groups. Statistical analyses were performed using SAS 9.3 From 114 patients with validated smoking status during the 1st trimester, 27 (24%) had quit during pregnancy. Demographics were similar among quitters and non-quitters. Patients who continued smoking had a significantly higher pro-inflammatory state, as seen by higher levels of 1st trimester IL-1a (p = .009), TNFα (p = .033) and CRP (p = .001), as well as 3rd trimester IL-1a (p = .014). The change in serum cytokine levels between trimesters (1st to 2nd / 2nd to 3rd) did not differ between the quitting and non-quitting groups. Multivariate regression analyses showed significantly increased TNF-α levels from the 1st to 3rd trimester (p = .009) among non-quitters, while adjusting for maternal age, BMI, race / ethnicity, education and income. Smoking cessation during pregnancy leads to a decrease in the pro-inflammatory milieu with the possibility of augmenting the anti-inflammatory environment. Smoking cessation thus has the potential to reduce adverse pregnancy outcomes linked to an increased inflammatory state.