Document Detail


Maternal smoking during pregnancy and neonatal behavior: a large-scale community study.
MedLine Citation:
PMID:  19403478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample.
METHODS: Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23% of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge.
RESULTS: Sixty-two percent of the sample reported smoking during pregnancy, with 24% of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone.
CONCLUSIONS: In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.
Authors:
Laura R Stroud; Rachel L Paster; Matthew S Goodwin; Edmond Shenassa; Stephen Buka; Raymond Niaura; Judy F Rosenblith; Lewis P Lipsitt
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  123     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-30     Completed Date:  2009-05-26     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e842-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Birth Weight
Female
Humans
Infant Behavior*
Infant, Newborn
Maternal Behavior
Pregnancy
Prenatal Exposure Delayed Effects / epidemiology*
Smoking / adverse effects*
Social Class
Grant Support
ID/Acronym/Agency:
P50 CA84719/CA/NCI NIH HHS; R01 HD043844/HD/NICHD NIH HHS; R01 HD043844/HD/NICHD NIH HHS; R01 HD043844-02/HD/NICHD NIH HHS; R40 MC03600//PHS HHS
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