Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
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DOI：
10.1016/j.jpeds.2008.07.048
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发表时间：
2009-01-01
影响因子：
5.1
通讯作者：
Lester, Barry
中科院分区：
文献类型：
--
作者：
Stroud, Laura R.;Paster, Rachel L.;Lester, Barry
目的探讨母亲孕期吸烟对10 ~ 27天新生儿神经行为的影响。研究设计参与者是56名健康婴儿（28名吸烟暴露。28个未暴露）与母亲的社会阶层相匹配。年龄和酒精使用。通过母亲访谈和母亲唾液可替宁确定母亲在怀孕期间是否吸烟。出生后的烟雾暴露定量婴儿唾液可替宁。婴儿神经行为通过NICU网络神经行为Scale.Results进行评估，吸烟暴露的婴儿表现出更大的需要处理和更差的自我调节（P <0.05）和倾向于更大的兴奋性和觉醒（P <0.10）相对于匹配，未暴露的婴儿（所有中等效果大小）。与之前的研究（0 - 5天）相比，吸烟暴露对压力/禁欲或肌肉张力的迹象没有影响。在分层，调整分析中，只有需要处理的影响仍然显着（P <0.05，大效应大小）。结论母亲在怀孕10至27天吸烟的影响是微妙的，并与外部干预和自我调节能力较差的需要增加。沿着养育缺陷，这些影响可能是母亲怀孕期间吸烟长期不良后果的早期前兆。先前对0至5天大的新生儿进行的研究显示，年龄较大的新生儿没有出现戒断迹象，这进一步证明了接触过该物质的婴儿可能存在戒断过程。（J Pediatr 2009..（154：10-6）
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 lire 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 it withdrawal process in exposed infants. (J Pediatr 2009..154:10-6)