Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
Received 21 February 2008; received in revised form 10 June 2008; accepted 22 July 2008. published online 06 November 2008.
Refers to article:
Looking Ahead to a Tobacco-Free Generation
, 06 November 2008
Cynthia F. Bearer, Matthew A. Stefanak
The Journal of Pediatrics
January 2009 (Vol. 154, Issue 1, Pages 4-5) Full Text |
Full-Text PDF (70 KB)
Mid-Pregnancy Cotinine and Risks of Orofacial Clefts and Neural Tube Defects
, 06 November 2008
Gary M. Shaw, Suzan L. Carmichael, Stein Emil Vollset, Wei Yang, Richard H. Finnell, Henk Blom, Øivind Midttun, Per M. Ueland
The Journal of Pediatrics
January 2009 (Vol. 154, Issue 1, Pages 17-19) Abstract |
Full Text |
Full-Text PDF (88 KB)
Objective
To examine effects of maternal smoking during pregnancy on newborn neurobehavior at 10 to 27 days.
Study design
Participants were 56 healthy infants (28 smoking-exposed, 28 unexposed) matched on maternal social class, age, and alcohol use. Maternal smoking during pregnancy was determined by maternal interview and maternal saliva cotinine. Postnatal smoke exposure was quantified by infant saliva cotinine. Infant neurobehavior was assessed through the NICU Network Neurobehavioral Scale.
Results
Smoking-exposed infants showed greater need for handling and worse self-regulation (P < .05) and trended toward greater excitability and arousal (P < .10) relative to matched, unexposed infants (all moderate effect sizes). In contrast to prior studies of days 0 to 5, no effects of smoking-exposure on signs of stress/abstinence or muscle tone emerged. In stratified, adjusted analyses, only effects on need for handling remained significant (P < .05, large effect size).
Conclusions
Effects of maternal smoking during pregnancy at 10 to 27 days are subtle and consistent with increased need for external intervention and poorer self-regulation. Along with parenting deficits, these effects may represent early precursors for long-term adverse outcomes from maternal smoking during pregnancy. That signs of abstinence shown in prior studies of 0- to 5-day-old newborns did not emerge in older newborns provides further evidence for the possibility of a withdrawal process in exposed infants.
aDepartment of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
bCenter for Statistical Sciences, Brown University, Providence, RI
cBrown Center for the Study of Children at Risk, Warren Alpert Medical School and Women and Infants' Hospital, Providence, RI
Reprint requests: Dr. Laura R. Stroud, Centers for Behavioral and Preventive Medicine, Warren Alpert Medical School and The Miriam Hospital, Brown University, Coro West, Suite 500, 1 Hoppin Street, Providence, RI 02903
Supported by NIH grants R03 DA14394 and K23 MH65443 and a Faculty Scholar Award from the Robert Wood Johnson Foundation to the first author. The sponsor (NIDA) did not play a role in (1) study design; (2) the collection, analysis, and interpretation of data; (3) the writing of the report; and (4) the decision to submit the paper for publication.
ABSTRACT