Smoking during pregnancy and newborn neurobehavior
Smoking during pregnancy and newborn neurobehavior
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DOI：
10.1542/peds.111.6.1318
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发表时间：
2003-06-01
期刊：
影响因子：
8
通讯作者：
Lester, BM
中科院分区：
文献类型：
--
作者：
Law, KL;Stroud, LR;Lester, BM
客观的。这是一项前瞻性研究，研究母亲在怀孕期间吸烟对新生儿神经行为的影响，包括使用自我报告和尼古丁暴露生物测定的剂量反应关系。方法。该样本包括 27 名接触过尼古丁的婴儿和 29 名未接触过尼古丁的足月新生儿，他们的社会阶层背景相当，没有任何医疗问题。母亲因在怀孕期间使用非法药物、使用抗抑郁药物或每月饮用超过 3 杯酒精饮料而被排除在外。尼古丁暴露量是通过母亲自我报告和母亲唾液中的可替宁来确定的。 NICU 网络神经行为量表（NNNS）由医院蒙面检查人员进行，用于测量神经行为功能。比较尼古丁暴露组和未暴露组之间的 NNNS 评分，包括对协变量的调整。计算母亲唾液可替宁的剂量反应关系与 NNNS 评分以及母亲怀孕期间每天吸烟数量的报告。结果。调整协变量后，接触烟草的婴儿更容易兴奋和高渗，需要更多的处理，并表现出更多的压力/禁欲迹象，特别是在中枢神经系统（CNS）、胃肠道和视觉区域。剂量反应关系显示，较高的母体唾液可替宁值与更多的压力/禁欲症状 (r = .530) 相关，包括中枢神经系统 (r = .532) 和视觉压力 (r = .688) 以及较高的兴奋性评分 (r = .617)。怀孕期间每天吸烟与更多的压力/戒断症状 (r = .582) 相关，包括中枢神经系统 (r = .561) 和视觉压力 (r = .640)。结论。这些发现表明产前烟草暴露对新生儿神经行为具有神经毒性作用。剂量-反应关系可能表明新生儿退出旨在了解怀孕期间吸烟对婴儿影响的研究可以改善公共卫生结果。
Objective. This was a prospective study of the effects of maternal smoking during pregnancy on newborn neurobehavior, including dose-response relationships using self-report and a bioassay of nicotine exposure.Methods. The sample included 27 nicotine exposed and 29 unexposed full-term newborn infants with no medical problems from comparable social class backgrounds. Mothers were excluded for using illegal drugs during pregnancy, using antidepressant medication, or if they consumed >3 alcoholic drinks per month. Nicotine exposure was determined by maternal self-report and cotinine in maternal saliva. The NICU Network Neurobehavioral Scale (NNNS) was administered by masked examiners in hospital to measure neurobehavioral function. NNNS scores were compared between nicotine-exposed and -unexposed groups including adjustment for covariates. Dose-response relationships with NNNS scores were computed for maternal salivary cotinine and maternal report of number of cigarettes per day during pregnancy.Results. After adjustment for covariates, the tobacco-exposed infants were more excitable and hypertonic, required more handling and showed more stress/abstinence signs, specifically in the central nervous system (CNS), gastrointestinal, and visual areas. Dose-response relationships showed higher maternal salivary cotinine values related to more stress/abstinence signs (r = .530) including CNS (r = .532) and visual stress (r = .688) and higher excitability scores (r = .617). Cigarettes per day during pregnancy was related to more stress/abstinence signs (r = .582) including CNS (r = .561) and visual stress (r = .640).Conclusions. These findings suggest neurotoxic effects of prenatal tobacco exposure on newborn neurobehavior. Dose-response relationships could indicate neonatal withdrawal from Research directed at understanding the effects of cigarette smoking during pregnancy on infants can lead to improved public health outcome.