Chorioamnionitis Causes Perinatal Illnesses Blamed on Smoking

"Acute chorioamnionitis is the largest contributor to the poor pregnancy outcomes of black women and women who have low socioeconomic status," and it is "the most common cause of preterm labor wherever it has been studied" (RL Naeye. Acute chorioamnionitis and the disorders that produce placental insufficiency. In: Monographs in Pathology No. 33, Pathology of Reproductive Failure. FT Krause et al., eds.Williams and Wilkins, 1991, Ch 10, pp 286-307).

Chorioamnionitis is the general term for infection of the amniotic membranes (the chorion, amnion, and placenta, and sometimes also the umbilical cord) by bacteria, mycoplasmas, and ureaplasmas during pregnancy. The infection weakens the membranes which results in their premature rupture. Inflammation causes swelling around the placental villa which reduces the flow of blood and causes hypoxia in the fetus, and by-products of bacteria and/or of fetal distress initiate preterm labor.

"Infants who are born preterm as the result of acute chorioamnionitis are often ill because their lungs, brains, and intestinal tracts are immature and because placental edema made them hypoxic before birth. Most of the morbidity associated with acute chorioamnionitis in preterm-born infants presents with signs of acute antenatal hypoxia (i.e., low Apgar scores, the need to resuscitate vigorously at birth, neonatal respiratory distress syndrome, and recurrent apneic episodes). These findings usually correlate much more strongly with the severity and extent of placental villous edema that is present than with the severity and stage of chorioamnionitis." (RL Naeye. Acute chorioamnionitis and the disorders that produce placental insufficiency. In: Pathology of Reproductive Failure. FT Krause et al., eds. Williams & Wilkins, 1991, Ch 10, pp 286-307.)

The bacteria can also make the baby ill. Pneumonia in newborns is nearly always caused by chorioamnionitis. Exposed neonates are also at greater risk of septicemia, and more rarely, of neonatal otitis media, meningitis, and septic arthritis.

Pathological examination of the placenta is necessary to determine the presence of chorioamnionitis in epidemiological studies, because there is sufficient clinical evidence to diagnose the infection in only about 10% of affected pregnancies. Even in cases that turned out to be fatal, there was sufficient clinical evidence for a diagnosis in only one fourth of them. (RL Naeye. Editorial. The investigation of perinatal deaths. NEJM 1983;309(10):611-612.)

The anti-smokers have falsely blamed smoking for all the ills caused by chorioamnionitis (preterm birth, premature rupture of membranes, stillbirth, septicemia and the other neonatal infections) by using defective studies which did not include pathological examinations of the placenta. Because chorioamnionitis is more common in women of lower socioeconomic status, and smokers are more likely to be of lower socioeconomic status, smoking got the blame instead.

"We recently found no significant association between maternal smoking and either stillbirths or neonatal deaths when information about the underlying disorders, obtained from placental examinations, was incorporated into the analysis. Similar analyses found no correlation between maternal smoking and preterm birth. The most frequent initiating causes of preterm birth, stillbirth, and neonatal death are acute chorioamnionitis, disorders that produce chronic low blood flow from the uterus to the placenta, and major congenital malformations. There is no credible evidence that cigarette smoking plays a role in the genesis of any of these disorders." (RL Naeye. Disorders of the placenta, fetus and neonate, diagnosis and clinical significance. CV Mosby Co., 1992.)

Naeye's study population was the 56,000 pregnancies of the Collaborative Perinatal Project, sponsored by the National Institutes of Neurological Diseases and Stroke of the National Institutes of Health, in which nearly 45,000 placentas were painstakingly examined. This is an enormous, gold-standard study with no equivalent in either size or quality, and the anti-smoking conspirators have purposely covered it up.

The anti-smokers refuse to even mention the subject of infection in their studies and reviews, let alone discuss its importance in the diseases for which they blame smoking. And if they mention Naeye's work, it is only his earlier, not his later publications. I personally brought this issue to the attention of the authors of the California EPA ETS report chapter on "Developmental Toxicity I: Perinatal Manifestations," Gayle Windham and Mari Golub. But there was no mention of this in the published "Summary of Public Comments and Responses."

And, they go right on repeating their false claims that maternal smoking is harmul to the babies even when the data make a mockery of this claim. In a masterpiece of pretense, last year HHS Secretary Donna Shalala spent 12 paragraphs gushing exuberantly about declines in teen pregnancy and rates of maternal smoking, and increases in prenatal care, all of which should supposedly be expected to improve birth outcomes, before reluctantly admitting the sorry truth in the second to last paragraph of her press release.

"In contrast to improvements in prenatal care and a reduction in maternal smoking, the rate of preterm births increased sharply in 1997 to 11.4 percent (437,000) and the proportion of infants born low birthweight (291,000) reached the highest level in over two decades, 7.5 percent." A lame excuse was attempted that this was "due in part to a remarkable rise in multiple births," before conceding that low birthweight has also risen among single births.

As Naeye observed in 1991, "Because the frequency of preterm births has hardly changed in the United States during the past three decades, it is unlikely that anything currently being done in the health care system is preventing these infections." For starters, the health establishment ought to stop deceiving the public and laying guilt trips on pregnant smokers. They should stop shoveling out money for medically worthless social engineering projects aimed at making them quit, and redirect the money to preventing and treating infection instead. Nonsmokers would benefit from this as well.

Cervical cultures and amniocentesis have been of negligible value in predicting outcome. Even in cases of preterm premature rupture of membranes, positive cultures of amniotic fluid were found in only 27.9%, and it was conceded that "This figure probably underestimates the true prevalence of intraamniotic infection" (R Romero et al. Infection in the pathogenesis of preterm labor. Semin Perinatol 1988;12(4):262-279). Besides, amniocentesis is an invasive procedure which introduces additional risks. Not even the recent directive to treat pregnant women with antibiotics to prevent complications from group B streptococcus appears to have made a dent in the problem, so perhaps treatment would have to be attempted earlier, before pregnancy occurs.

An example of the CDC's scientific fraud of deliberately using defective studies to falsely blame smoking for perinatal illness caused by chorioamnionitis: Medical-Care Expenditures Attributable to Cigarette Smoking During Pregnancy -- United States, 1995. MMWR 1997 Nov 7;46(44):1048-1050 (pages 12-14 of pdf document).

New studies

The contribution of pathological examination of the placenta in the investigation of the causes of foetal mortality. E Agapitos, C Papadopoulou, N Kavantzas, J Papoulias, V Antonaki, P Davaris. Arch Anat Cytol Pathol 1996;44(1):5-11. "Three hundred (300) placentas were examinated over a period of three years (1988-1991). The clinical history, autopsy examination and placental histological examination were taken into account to determine the cause of death. Autopsy findings revealed the cause of death in only 33 cases (12.9%). In contrast, placental examination allowed us to determine the cause of death in 123 cases (48.4%) especially in abortions (54.4%). The most frequent abnormalities found were vascular insufficiency in intrauterine deaths (16.47%) and acute chorioamnionitis with foetal involvement in abortions (31.4%). Fifty six (56) cases with diagnoses of acute chorioamnionitis, chronic villitis of unknown aetiology and erythroblastosis were classified in the highrisk group for a subsequent pregnancy."

"Preterm delivery is the chief problem in obstetrics today, accounting for 70 percent of perinatal mortality and nearly half of long-term neurologic morbidity. Approximately 10 percent of all births are preterm, but most of the serious illness and death is concentrated in the 1 to 2 percent of infants who are born at less than 32 weeks of gestation and who weigh less than 1500 g. Approximately 20 percent of preterm births are the result of a physician's decision to bring about delivery for maternal or fetal indications, and the remainder follow the spontaneous onset of labor or rupture of the membranes." Intrauterine Infection and Preterm Delivery. RL Goldenberg, JC Hauth, WW Andrews. NEJM 2000 May 18;342(20):1500-1507.) Review.

Adeno-associated virus DNA in human gestational trophoblastic disease. K Kiehl, JR Schlehofer, R Schultz, M Zugalb, E Armbruster-Moraes. Placenta 2002 May;23(5):410-415. "AAV DNA was found in 43 samples (28/49 hydatiform moles, 4/14 choriocarcinomas, 11/15 miscarriage material material)."

Patterns of colonization with Ureaplasma urealyticum during neonatal intensive care unit hospitalizations of very low birth weight infants and the development of chronic lung disease. S Castro-Alcaraz, EM Greenberg, DA Bateman, JA Regan. Pediatrics 2002 Oct;110(4):e45. "We found a significantly higher rate of CLD at 28 days of age (odds ratio: 8.7; 95% confidence interval: 3.3, 23) and at 36 weeks' postconceptional age."

Correlation of in situ detection of infectious agents in the placenta with neonatal outcome. L Genen, GJ Nuovo, L Krilov, JM Davis. J Pediatr 2004 Mar;144(3):316-320. "Placental tissue from 33 newborn infants with systemic illness and poor neonatal outcome [death or significant neurodevelopmental abnormalities] were tested by in situ hybridization or reverse transcriptase-polymerase chain reaction for infectious pathogens. Control placentas came from mothers delivering infants with poor neonatal outcome of known cause (ie, cord prolapse, uterine rupture), mothers with known infections, and normal births (n=21). RESULTS: There were 5 deaths among the newborn infants, and all survivors had poor neonatal outcome. Placentas from 24 of 33 cases (73%) had positive test results for Coxsackie virus (46%), bacteria (38%), herpes (8%), and parvovirus (4%) and picornavirus (4%). At autopsy, multiple organs from the newborn infant had positive test results for the same organism isolated from the placenta."

Histologic correlates of viral and bacterial infection of the placenta associated with severe morbidity and mortality in the newborn. A Satosar, NC Ramirez, D Bartholomew, J Davis, GJ Nuovo. Hum Pathol 2004 May;35(5):536-545. 77 cases, "either fetal or neonatal death (11 cases with autopsy material available in 8 cases) or idiopathic severe respiratory distress or central nervous system-related symptoms at birth (49 cases). Controls included 11 placentas from births with no morbidity and 6 placentas that were associated with severe neonatal morbidity of known etiology (trisomy, ruptured uterus, prolapsed cord).... An infectious cause was found in 46/60 (76%) of cases; these were distributed as follows: enterovirus, 23 cases (22 were coxsackie virus); bacterial (consensus probe), 15 cases; cytomegalovirus (CMV), 4 cases; herpes simplex virus (HSV), 2 cases; parvovirus, 2 cases. The infectious agents localized primarily to Hofbauer cells and trophoblasts. In each of the 8 cases for which autopsy material was available, the same infectious agent that was detected in the placenta was also detected in the autopsy material (spleen, heart, central nervous system, or lungs). No infectious agent was detected in any of the 17 controls."

Histologic, infectious, and molecular correlates of idiopathic spontaneous abortion and perinatal mortality. GJ Nuovo, LD Cooper, D Bartholomew. Diagn Mol Pathol 2005 Sep;14(3):152-158. "Placentas and corresponding neonatal tissues in 21 consecutive cases of idiopathic spontaneous abortion or perinatal death, before or within 2 days of birth, were tested for an infectious agent. The controls included 10 consecutive cases of fetal and placental tissues from therapeutic abortions, 5 placentas from unremarkable childbirths, and 11 placentas from cases of spontaneous abortion or perinatal death of known cause (ruptured uterus, placenta abruption, prolapsed cord). An intrauterine infection was noted in 16 of 21 (76%) of the placentas associated with neonatal mortality; in each case, the same infectious agent was found in the neonatal tissues, primarily the spleen. The most common infectious agent was enterovirus/coxsackie virus (10 cases); the histologic findings in the placenta were nonspecific. There was strong expression of TNF-alpha in the placenta and spleen of each of the cases of intrauterine infection and in none of the 26 controls."

Universal DNA primers amplify bacterial DNA from human fetal membranes and link Fusobacterium nucleatum with prolonged preterm membrane rupture. RJ Cahill, S Tan, G Dougan, P O'Gaora, D Pickard, N Kennea, MH Sullivan, RG Feldman, AD Edwards. Mol Hum Reprod 2005 Oct;11(10):761-766. "The commonest organism Fusobacterium nucleatum was found in 9/15 (60%) of samples. Ten of the 12 samples obtained after prolonged membrane rupture were positive for bacterial DNA, and 7 of these (70%) contained DNA from F. nucleatum."

Proteomic profiling of the amniotic fluid to detect inflammation, infection, and neonatal sepsis. CS Buhimschi, V Bhandari, BD Hamar, MO Bahtiyar, G Zhao, AK Sfakianaki, CM Pettker, L Magloire, E Funai, ER Norwitz, M Paidas, JA Copel, CP Weiner, CJ Lockwood, IA Buhimschi. PLoS Med 2007 Jan 16;4(1):e18. In 169 consecutive women with singleton pregnancy following admission at Yale-New Haven Hospital with symptoms of premature labor (PTL), advanced cervical dilatation, and/or preterm premature rupture of membranes (PPROM). All degrees of inflammation were associated with preterm birth, regardless of membrane status. "There was a significant association between the MR score and severity of histological chorioamnionitis (r = 0.599, p < 0.001)." "When compared with other laboratory tests routinely used to diagnose amniotic fluid inflammation and infection, the MR score had the highest accuracy to detect inflammation." "Premature birth is fairly common, with around 12% of births in the US fitting this definition. However, it has serious consequences, being responsible for around 70% of infant deaths and other adverse outcomes for the baby. It is not clear in all cases what directly causes premature birth or how to identify cases in which mother and child are at greater risk of serious outcomes. Evidence from case-control and other studies strongly suggests that infections of the uterus, placenta, or genital tract are associated with, and are likely to directly cause, premature deliveries. Such infections, even if they are “subclinical” (that is, they do not directly cause signs or symptoms that the doctor or patient would notice) cause inflammation in the affected tissues... This study showed that the MR score was closely associated with a number of different indicators of poor outcome in preterm birth. These outcomes included sooner deliveries, sepsis in the baby, and inflammation in the placenta." Among those with positive microbial culture results, the most common isolates were Ureaplasma urealyticum (17/44), Streptococcus species (9/44), and Bacteroides species (5/44).

"Of 459 stillbirths, 428 stillbirths were included. The incidence of chorioamnionitis was 36.9%, with higher rates evident in early and late gestation. A fetal inflammatory response was present in 13.3% and correlated with spontaneous labor and very early spontaneous preterm death. The absence of a fetal response was associated with unexplained antepartum death." (Chorioamnionitis and fetal response in stillbirth. MM Lahra, A Gordon, HE Jeffery. Am J Obstet Gynecol 2007 Mar;196(3):229.e1-4; Chorioamnionitis and Fetal Response Tied to Stillbirth. Reuters Health 2007 Mar 30.)

BECAUSE OF THIS VICIOUS LIE THAT SMOKING HARMS THE FETUS, AN ANTI-SMOKER SHOT A PREGNANT WOMAN!

"Most people cringe at the sight of a pregnant woman smoking. Some people feel strongly enough to say something in protest. But one local man took matters into his own hands early Friday when, according to police, he shot an expectant mother who refused to put out her cigarette..." (Pregnant woman shot over cigarette 18-year-old refused to stop smoking. By Michael Perlstein Staff writer/The Times Picayune Oct. 5, 2002.)

Premature births in the US have increased for over two decades, despite persecution of smokers

"Premature births have hit their highest level in two decades, making up roughly 12 percent of the 4,025,933 newborns in 2001. Premature babies - those born earlier than 37 weeks of gestation - are often underweight. Not surprisingly, the incidence of low birth weight infants - defined as weighing less than about 5.5 pounds - rose to 7.7 percent of deliveries, up more than 13 percent since the mid-1980s." This was despite the persecution of pregnant smokers to make them quit, the workplace and public smoking bans, and smokers intimidated out of smoking in their own homes by the false and reckless accusations of the "health authorities." It was also despite increased rates of prenatal care, and a decrease in the number of births to teenagers. Experts lamely attempted to blame an increase in induced labor and multiple births, which make up only a small percentage of the total. (More Women Receiving Prenatal Care. By Adam Marcus, HealthScoutNews Reporter, Dec. 18, 2002. Source: Joyce Martin, MPH, statistician, National Center for Health Statistics; Health and Human Services Report, "Births: Final Data For 2001," Dec. 18, 2002.)

The truth: "The rate of premature births jumped from 9.4 percent of live births in 1981 to 11.9 percent in 2001, [Dr. Nancy S.] Green says, and the March of Dimes would like to see the rate lowered to no more than 10.1 percent of live births. The public is largely misinformed about what causes premature delivery, two March of Dimes surveys found. One survey of 600 pregnant women and a second of 2,000 men and women found that two-thirds of both groups felt that premature births were due to a mother not taking care of herself -- smoking, abusing drugs or not getting prenatal care. That's because doctors thought so, too, says Dr. Ian Holzman, chief of newborn medicine at New York City's Mount Sinai School of Medicine. 'It has been medicine's perception that if we can just get everybody into prenatal care, we'll stamp out prematurity, but it isn't that simple,' he says. 'Premature deliveries continue to be a major health issue, and what is disturbing is that the rates haven't come down even though other areas of health care have improved. This campaign is important.'" (Premature Births on the Rise. By Janice Billingsley. HealthScoutNews, Jan. 30, 2003.)

"Nationwide, the rate of premature births jumped 13% between 1992 and 2002, with seven states showing increases of 30 percent or more... 'This is alarming news,' says Dr. Jennifer L. Howse, president of the March of Dimes. 'Premature birth is now the most common, serious and costly infant health problem facing our nation. Last year annual hospitalization of these infants cost $13.6 billion. As a nation we must address this growing crisis in infant health and make it a priority....' Other data from the new report from the National Center for Health Statistics: The premature birth rate in 2002 rose to 12.1 percent of live births, up from 11.9 percent in 2001." (Premature Birth Rate in U.S. Reaches Historic High; Now Up 29 Percent Since 1981. March of Dimes Press Release, Feb. 3, 2004.)

"Some 12.3 percent of all babies – 499,008 infants -- were born prematurely (less than 37 weeks gestation) in 2003, according to the report released by the National Center for Health Statistics (NCHS). That’s up from 12.1 percent (or about 480,000 babies) in 2002 – and an increase of more than 30 percent since the government began tracking premature births in 1981. The prematurity rate was 9.4 in 1981; it has increased every year since then except for slight dips in 1992 and 2000.... The NCHS report, entitled “Births Final Data for 2003” appeared in the National Vital Statistics Report, volume 54, number 2." (Number of Babies Born Prematurely Nears Historic Half Million Mark in U.S. March of Dimes Press Release, Sep. 8, 2005.)

"The preterm birth rate, the percentage of babies born at less than 37 completed weeks gestation, now is 12.5 percent and has increased more than 30 percent since 1981, when the government began tracking premature birth. More than 71% of preterm infants were born between 34 and 36 weeks gestation and are considered “late preterm.” The NCHS report confirms a March of Dimes finding that those born late preterm are the fastest growing subgroup of premature babies.... The NCHS report confirmed an increase in the percent of babies born with low birthweight from 7.9 percent in 2003 to 8.1 percent in 2004..." (Government Data Confirms Rise in Preterm Birth Rate. March of Dimes Press Release, October 2, 2006.)

Fraudulent claims of "smoking costs"

Estimation of the break-even point for smoking cessation programs in pregnancy. M Shipp, MS Croughan-Minihane, DB Petiti, AE Washington. American Journal of Public Health 1992 Mar;82(3):383-390. Preterm low birth had the most impact on the cost: "For instance, in a population studied recently with a high incidence of and high relative risk for preterm LBW, the break-even cost was $237." The study was intended to justify the cost of quit-smoking programs for pregnant smokers, with imaginary "savings" supposedly to result from the decreased rates of preterm low birthweight which have never materialized. The authors were all at the School of Medicine of the University of California at San Francisco, the home of anti-smoker Stanton A. Glantz. It was funded by a fellowship grant from the Pew Charitable Trusts, and with money from the California cigarette and tobacco surtax from the Tobacco-Related Disease Research Program of the University of California.

The Department of Health and Human Services LIES through their teeth.

(From Healthy People 2010): "The general category of LBW infants includes both those born too early (preterm infants) and those who are born at full term but who are too small, a condition known as intrauterine growth retardation (IUGR). Maternal characteristics that are risk factors associated with IUGR include maternal LBW, prior LBW birth history, low prepregnancy weight, cigarette smoking, multiple births, and low pregnancy weight gain. Cigarette smoking is the greatest known risk factor." This claim, that "Cigarette smoking is the greatest known risk factor" for low birth weight is a deliberate, conscious lie, created by ignoring the role of chorioamnionitis in preterm birth and its greater prevalence among the lower socioeconomic classes, in which smokers are more likely to be found; and lumping healthy births of lower weight together with low birth weights caused by disease, in order to create the false impression that increasing birth weight alone would improve health - which it does not.

"VLBW usually is associated with preterm birth. Relatively little is known about risk factors for preterm birth, but the primary risk factors are prior preterm birth and spontaneous abortion, low prepregnancy weight, and cigarette smoking. These risk factors account for only one-third of all preterm births." This is the same lie again, plus that outrageous weasel that "Relatively little is known" as a pretext for ignoring what IS known - namely, that chorioamnionitis is the most important cause of preterm birth, and their list of so-called "risk factors" is a lie by omission.

The Big Lie of "Smoking-attributable costs of complicated births"

"Smoking-attributable costs of complicated births in 1995 were estimated at $1.4 billion (11 percent of costs for all complicated births, based on smoking prevalence during pregnancy of 19 percent) and $2.0 billion (15 percent for all complicated births, based on smoking prevalence during pregnancy of 27 percent)." This is based on a claim that complicated births in smokers cost more than complicated births in non-smokers, which is based, not upon direct comparison, as most readers presume, but on using multivariate analysis to concoct fictitious costs of smokers versus non-smokers. [A hint to the clueless: direct comparison of costs does NOT involve multivariate analysis!] Their statistical fraud falsely presumes that smokers' costs are higher than they 'should have been' based on the amount of prenatal care they received. But the established ineffectuality of prenatal care to prevent the leading complication, preterm birth, makes their ritual adjustment for prenatal care a means of creating confounding, not preventing it. Then, they use the phony excess plus the rates of smoking during pregnancy to concoct a bogus "smoking-attributable fraction" and "smoking-attributable cost," as per the CDC's infamous SAMMEC (Smoking-Attributable Mortality, Morbidity and Economic Costs) computer program. This is the fraudulent source article: Medical-Care Expenditures Attributable to Cigarette Smoking During Pregnancy -- United States, 1995. MMWR November 07, 1997 / 46(44);1048-1050.

Healthy People 2010 Lies

"Smoking accounts for 20 to 30 percent of all LBW births in the United States. The effect of smoking on LBW rates appears to be attributable to intrauterine growth retardation rather than to preterm delivery." They are deliberately misusing words to confuse mere smaller size in healthy term infants, with a distinct and serious medical condition called intrauterine growth retardation (IUGR), which is associated with pre-eclampsia and chronic maternal hypertension, that cause low uteroplacental blood flow and markedly reduce fetal growth.

Healthy People 2010. 16. Maternal, Infant, and Child Health. Co-Lead Agencies: Centers for Disease Control and Prevention, Health Resources and Services Administration.

RWJF Funded the SAMMEC Maternal Smoking Costs Fraud

The lying scum simply proclaim grandiosely that "The causal association between maternal smoking and maternal morbidity, infant mortality, and infant morbidity is well established" - ignoring the fact that this phony "causal association" was manufactured with the use of studies which had no placental examinations for chorioamnionitis. (Costs of smoking during pregnancy: development of the Maternal and Child Health Smoking Attributable Mortality, Morbidity and Economic Costs (MCHSAMMEC) software. Cathy L Melvin, E Kathleen Adams, Vince Miller. Tob Control 2000;9(Suppl 3):iii12-iii15(Autumn).) The development of this fraudulent computer program was funded by The Robert Wood Johnson Foundation. (Adams EK. Development of the Maternal and Child Health (MCH) Smoking Attributable Morbidity, Mortality, and Economic Cost (SAMMEC) Model: Final Report to the Robert Wood Johnson Foundation (under grant 022247); 1999. In: Prenatal Smoking Book Data: References. Centers for Disease Control and Prevention. Date last reviewed: 03/29/2006.) Melvin was one of the co-authors of this book.

Cathy L. Melvin is the Project Director of a $1,399,902 grant from the Robert Wood Johnson Foundation running from May 1, 2002 to Jun 30, 2007 (ID# 045257 ) to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina - Chapel Hill, for "Marketing and communications support for the Smoke-Free Families National Partnership to Help Pregnant Smokers Quit." The Sheps Center was designated the National Dissemination Office of RWJF's Smoke-Free Families project and has been funded by them since 1994. Melvin is also the author of fraudulent claims about “Smoking and Reproductive Health” in the Surgeon General’s Report on Smoking and Women’s Health, 2001, and other anti-smoking dreck.

"Last year, Carolina received more than $7.6 million in research funding from the foundation.... A $5 million gift in 2000 established the NDO at UNC-Chapel Hill." Cathy L. Melvin, research associate professor of maternal and child health and director of NDO, lies that "[Smoking] causes over 1,000 infant deaths per year and is the single biggest preventable cause of premature and low birth weight babies." (Robert Wood Johnson Foundation grants to help pregnant women quit smoking, dentist shortage. Carolina Connections, Spring 2003.)

March of Dimes Collusion with the Anti-Smokers

The March of Dimes lies that "Smokers have smaller babies than nonsmokers, on average, and maternal exposure to another person's smoking may also decrease the baby's birthweight," and falsely pretends that therefore, elimating these factors would eliminate the adverse health conditions that are the real cause of low birthweight.

Bonnie Dobrowolski, Assistant Director of Public Health Education of the March of Dimes, participated in Work Group 1, "Prevention of Smoking Through Comprehensive School Health Education," of the National Conference on Smoking or Health, Nov. 18, 1981.

Irwin Tobin, Director of Public Education, Greater New York Chapter of the March of Dimes, participated in Work Group 2, "Use of 'High Risk' Concept in Smoking Control." Its Group Leader was Lester Breslow.

Edward A. Franck, Vice President for Public Information of the March of Dimes, participated in Work Group 8, "Countering Cigarette Advertising and Supporting the Rights of Nonsmokers Through the Media" (this is how these subhuman vermin mischaracterize a systematic campaign of deliberate psychopathic lies and defamations against smokers) of the 1981 National Conference on Smoking or Health.Edward L. Bernays was also a participant.

The March of Dimes Still Lies

"Smoking is a known cause of some cases of preterm birth, low-birthweight and very low-birthweight, resulting in increased neonatal deaths and increased health care costs." LIE. Those studies are based on deliberately fraudulent studies that ignore the role of chorioamnionitis. "Nearly 13% of low birthweight deaths are due to smoking. About 18% of Sudden Infant Deaths are attributable to smoking. (WI Burden of Tobacco Report, DHFS)" The SIDS studies ignore infection as well, and the Wisconsin Burden of Tobacco Report is nothing but a mini version of the SAMMEC, which uses the same fraudulent methods. "Prematurity/low birthweight is one of the costliest reasons for a hospital stay. Charges averaged $58,000 for these stays. Of these babies 10% had charges of at least $146,000. By contrast, stays for newborns typically average $4,300. (March of Dimes Data Book for Policy Makers, 2003)" And, as the March of Dimes is fully aware, the rates of preterm birth have steadily risen, despite persecution of smoking. (Pregnancy and Smoking in Wisconsin. March of Dimes, Wisconsin Chapter. Accessed Mar. 3, 2006.)

"Scheduling a preconception check-up is the most important New Year’s resolution a woman planning to have a baby can make." [Then why have the rates of preterm birth steadily increased despite higher rates of prenatal care? Perhaps these people ought to read their own press releases before they babble.] "Don’t smoke and avoid second hand smoke. Smoking increases the risk of premature birth." [LIAR! Then why why have the rates of preterm birth steadily increased despite lower rates of smoking?] (March of Dimes New Years' Resolutions for a Healthy Baby. March of Dimes Press Release, Dec. 22, 2006.)

Don't Give to the March of Dimes

The March of Dimes actively lobbied for SF 128, the extortionate 2007 state cigarette tax increase in Iowa (lobbyists - Erika Anderson, John Pederson, Lorelei Heisinger).

Sepsis, Pneumonia, and Meningitis

Epidemiology of group B streptococcal disease in the United States: shifting paradigms. A. Schuchat. Clin Microbiol Rev 1998 Jul;11(3):497-513. (Review) Group B streptococci (GBS) are the leading cause of sepsis and meningitis in newborns.

Prevention of Perinatal Group B Streptococcal Disease. Revised Guidelines from CDC. S Schrag, R Gorwitz, K Fultz-Butts, A Schuchat. MMWR August 16, 2002;51(RR11):1-22. "The majority of infections in newborns occur within the first week of life and are designated early-onset disease. Late-onset infections occur in infants aged >1 week, with most infections evident in the first 3 months of life. Young infants with invasive GBS disease usually present with sepsis or pneumonia, and less often contract meningitis, osteomyelitis, or septic arthritis. The proportion of infants with meningitis is higher among those with late-onset infections.... In addition to colonization with GBS, other factors increase the risk for early-onset disease. These include gestational age <37 completed weeks, longer duration of membrane rupture, intraamniotic infection, young maternal age, black race, Hispanic ethnicity, and low maternal levels of anticapsular antibody."

Hyperinvasive neonatal Group B Streptococcus has arisen from a bovine ancestor. N Bisharat, DW Crook, J Leigh, RM Harding, PN Ward, TJ Coffey, MC Maiden, T Peto, N Jones. J Clin Microbiol 2004 May;42(5):2161-2167. "Streptococcus agalactiae, the species designation of GBS, was initially described in 1887 as an animal pathogen causing bovine mastitis. Human infections caused by this bacterium were only reported 50 years later, in the 1930s. Neonatal disease, though, was rarely reported. However, during the 1960s numerous reports linked neonatal infections with this organism, and by the 1970s, GBS had become the leading neonatal pathogen in much of the developed world and has remained so ever since.... The phylogenetic evidence indicates that the human isolate ST-17 complex, the major hyperinvasive neonatal clone (which accounts for 30% of neonatal infections [N. Jones, unpublished data]), has arisen from a bovine lineage.... The finding that the ST-17 complex accounts for a proportion of strains carried by adults (Table 1) suggests that it is now autonomously circulating within the human population."

Perinatal infections due to group B streptococci. RS Gibbs, S Schrag, A Schuchat. Obstet Gynecol 2004 Nov;104(5 Pt 1):1062-1076. "Group B streptococci (GBS) emerged dramatically in the 1970s as the leading cause of neonatal infection and as an important cause of maternal uterine infection.... In 1996, the first national consensus guidelines were released. Since then, there has been a 70% reduction in early-onset neonatal GBS infection, but no decrease in late-onset neonatal GBS disease."

Genome sequence of a serotype M28 strain of group a streptococcus: potential new insights into puerperal sepsis and bacterial disease specificity. NM Green, S Zhang, SF Porcella, MJ Nagiec, KD Barbian, SB Beres, RB LeFebvre, JM Musser. J Infect Dis 2005 Sep 1;192(5):760-770. "Puerperal sepsis, a major cause of death of young women in Europe in the 1800s, was due predominantly to the gram-positive pathogen group A Streptococcus.... Importantly, genes for 7 inferred extracellular proteins are encoded by a 37.4-kb foreign DNA element that is shared with group B Streptococcus and is present in all serotype M28 strains. Proteins encoded by the 37.4-kb element were expressed extracellularly and in human infections. Acquisition of foreign genes has helped create a disease-specialist clone of this pathogen."

Early-Onset and Late-Onset Neonatal Group B Streptococcal Disease --- United States, 1996--2004. [Many contributors]. MMWR December 2, 2005;54(47):1205-1208. Note the rapid decline in early-onset disease attributable to antibiotics, versus the lack of change in late-onset disease, despite decreases in rates of smoking during 1996 to 2004.

Coxsackie Viruses and Developmental Delays

A study of school children who had identified virus infections of the central nervous system during infancy. RN Chamberlain, PN Christie, KS Holt, RM Huntley, R Pollard, MC Roche. Child Care Health Dev 1983 Jan-Feb;9(1):29-47. "Forty-nine children who had a virus infection of the central nervous system (CNS) when under 1 year of age were studied. One child had died during the initial illness and three of the survivors were severely disabled. The other survivors, more than 5 years after the initial illness, were all attending normal schools.... We confirm the findings of other studies that virus infections of the CNS in infancy may cause severe disabilities in some cases, and may depress intellectual abilities in others, even though they appear to have recovered fully. Many of the children who had a virus infection of the CNS in infancy had adverse birth and social histories and so were exceptionally vulnerable, but these factors did not account fully for the findings, and when their influence was included in the analysis, the index children still had a mean performance IQ (WISC) 6 points lower than the control children (P less than 0.05), whereas there was less than 1 point difference between the verbal IQs.

Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn. E Euscher, J Davis, I Holzman, GJ Nuovo. Obstet Gynecol 2001 Dec;98(6):1019-1026. "Coxsackie virus RNA was detected in six of the seven cases, and in none of the ten normal controls or five cases with known viral infection. Viral RNA localized primarily to the Hofbauer cells and trophoblasts of the terminal villi. Immunohistochemical analysis for the coxsackie virus antigen VP1 yielded equivalent results." "Six of the seven children ranged in age from 4 to 15-years-old, and included five boys. One child died 1 day after birth. Each of the six living children experienced marked, global cognitive defects evident soon after birth, which required intensive physical therapy, occupational therapy, and, occasionally, antiseizure therapy, and institutional therapy. All children (except for case 4 below) have not shown evidence of cerebral palsy because there have been minimal motor-related symptoms." "The most common histologic finding in the 12 placental cases (five known viral infections and the seven cases included in this report) was Hofbauer cell hyperplasia, which was seen in all cases except one with herpes simplex virus infection; this was not evident in the ten normal control tissues. Four of the five cases of known viral infection showed focal calcification, and each showed focal chronic villitis as well as focal hemorrhagic vasculitis. In comparison, of the seven cases associated with profound neurologic sequela, three showed focal chronic villitis, two showed focal hemorrhagic endovasculitis, and one showed focal calcifications."

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cast 01-17-08