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The study noted that over 9% of them reported smoking cigarettes before pregnancy, 7% during the first trimester, 6% in the second trimester, and around 6% in the third trimester

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This was associated with reduction in antioxidant enzymes and biomarkers including superoxide dismutase for acute and chronic hookah smoke exposures, and catalase, glutathione peroxidase, and thiobarbituric acid reactive substances for chronic exposure [196]

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