Comparing the lipid levels of pregnant women and their neonates according to presence or absence of environmental tobacco exposure. Seyyed Mohammad Hassan Aletayeb 2 , Masoud Dehdashtian 2* , Mohammad Reza Aramesh 2 , Arash Malakian 2 , Ali Monjezi 1 1 Pediatrician, Department of Pediatrics, Abu Zar Children's Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran 2 Neonatologist, Department of Pediatrics, Imam Khomeini Hospital, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Abstract We aimed to study lipid levels in pregnant women and their neonates according to the presence or absence of environmental tobacco exposure (ETS). The study was performed in 150 pair of mothers and neonates subjects who were divided into 2 groups: those who were exposed to ETS and those who were not. 300 blood samples were analyzed for total cholesterol, triglycerides, apolipoproteins A (Apo A) and B (Apo B), and C-reactive protein (CRP). Statistically significant differences were found in TG (60 ± 229 vs. 46 ± 204 mg/dl) and Apo A (30 ± 213 vs. 33 ± 192 mg/dl) levels between the mothers in the case group and the control group (p=0.036 and p=0.02, respectively). Apgar scores in neonates of mothers exposed to ETS were significantly lower (8 ± 1) than those for neonates of mother not exposed (9 ± 0.5) (p=0.038). Expose of pregnant women to ETS causes significant increases of their serum triglyceride and Apo A, while also increasing serum CRP and decreasing Apgar scores in their neonates. Keywords: Environmental tobacco smoke, Pregnant, Neonate, Triglyceride, Apgar score. Accepted on October 14, 2016 Introduction Many studies have asserted that smoking during pregnancy is unsafe for women and poses risks such as low birth weight, respiratory, and mental health problems (e.g., cerebral palsy, mental retardation, and learning problems) to the fetus. It also increases the risk of infertility in women and causes ectopic pregnancy (i.e. pregnancy outside the womb), miscarriage, and placental abnormalities. Fetuses of smoking mothers are two times more prone to sudden infant death syndrome (SIDS). Neonates of mothers who smoke during pregnancy are at increased risk of respiratory problems such as asthma, and most of them have learning difficulties and behavioural problems too [1]. Smoking during pregnancy is harmful to the immune systems of newborn infants. The damage to the immune system reveals the cause of increased prevalence of asthma and respiratory problems in the neonates of smoking mothers. Fetuses of such mothers are more prone to respiratory infections than are nonsmoking mothers [2]. There are several studies on the harmful effects of smoking or exposure to smoke during pregnancy. The consequences of breathing second-hand smoke during pregnancy include an increased rate of spontaneous miscarriage, pre-term delivery, placental, placenta previa, growth restriction, premature rupture of membranes (PROM), and stillbirth. Second-hand smoke breathed in during pregnancy also increases morbidity and mortality in newborn babies. In addition, the rates of developmental disorders, chronic heart disease, diabetes, cancer, and reproductive disorders increase [3,4]. Furthermore, several meta-analyses and review studies have shown that exposure to second-hand smoke chronically increases the incidence of cardiovascular disease by 30% [5,6]. This increased risk is due to the inflammatory effects of impaired vascular endothelium function, platelet aggregation, lipid peroxidation, and changes in C-reactive protein (CRP) [7-9]. Another factor that may increase the risk of cardiovascular diseases in those who breathe in second-hand smoke is its impact on the lipids and lipoproteins. Tobacco smoke boosts oxidative modification of low-density lipoprotein (LDL), leading to increases in oxidized LDL (Ox-LDL) in the bloodstream [5,10,11]. On the other hand, epidemiologic studies have shown that cigarette smoke decreases high-density lipoprotein (HDL) and changes LDL/HDL and triglyceride/HDL ratios [6,12,13]. These changes in lipid profile, particularly the changes in HDL/cholesterol ratio, make those who breathe in second-hand smoke particularly prone to cardiovascular diseases [14]. Nutraceuticals and functional food ingredients that are beneficial to vascular health may represent useful compounds that are able to reduce ISSN 0970-938X www.biomedres.info Biomed Res- India 2017 Volume 28 Issue 5 2199 Biomedical Research 2017; 28 (5): 2199-2203