New evidence strengthens link between
cigarette smoke exposure and poor infant health
effects of smoking and smoke exposure can be seen at any
age. Pediatricians have even noted these negative effects in
various stages of infant development. The consequences of
maternal smoke exposure during pregnancy can range from
higher rates of prematurity to increased risk of sudden
infant death syndrome. Two new studies and an
accompanying editorial soon to be published in The Journal
of Pediatrics examine several physical and behavioral
effects of cigarette smoke exposure on infants.
In an attempt to understand the relationship between
maternal smoking and certain birth defects, Dr. Gary Shaw of
the March of Dimes and colleagues from institutes in Norway,
Holland, and Texas, studied serum samples collected between
2003 and 2005 from pregnant women enrolled in the California
Expanded AFP (alpha fetoprotein) program. The researchers
measured the levels of cotinine, a metabolite of nicotine,
to determine whether the mothers smoked during pregnancy.
They found that women who smoked during pregnancy were
nearly 2.5 times more likely to have babies with oral
clefts. According to Dr. Shaw, "Babies with oral clefts
require significant medical care–often four surgeries by age
two–and may have speech, hearing, and feeding problems."
In a related study, Dr. Laura Stroud and colleagues from
Brown University studied the effects of cigarette smoke
exposure on infant behavior. The researchers studied 56
otherwise healthy infants and used questionnaires and
cotinine measurements to determine cigarette smoke exposure.
They found that the 28 babies who had been exposed to
cigarette smoke were more irritable and difficult to sooth
than the 28 babies who were not exposed. Dr. Stroud stresses
the importance of cessation programs for smoking mothers, as
well as programs to help new mothers manage a baby who is
difficult to soothe.
Offering a fresh perspective in their related editorial, Dr.
Cynthia Bearer of the University of Maryland and Matthew
Stefanak of the Mahoning County District Board of Health in
Ohio consider the findings of the two studies as further
evidence that smoking is a major pediatric problem. Citing
the fact that 90% of smokers start smoking by the age
of 18, Dr. Bearer sees prevention as the best solution and
stresses the need to stop smoking before it starts.
According to Dr. Bearer, "Proven prevention measures include
having family dinners and focusing on the negative body
impact of smoking." She suggests that the graphic
portrayal of the damaging effects of tobacco use on health
and physical attractiveness may be effective in deterring
teens from smoking. Because parents who actively
disapprove of smoking can help their children avoid the
harmful effects of cigarette smoke exposure, Dr. Bearer
encourages parents to take an active role in smoking
"Maternal Smoking during
Pregnancy and Newborn Neurobehavior: Effects at 10-27 Days"
by Laura R. Stroud, PhD, Rachel L. Paster, BA, George D.
Papandonatos, Raymond Niaura, PhD, Amy L. Salisbury, PhD,
Cynthia Battle, PhD, Linda L. Lagasse, PhD, and Barry
Lester, PhD. DOI 10.1016/j.jpeds.200807.048
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