Control of breathing in infants born to smoking mothers

To determine whether infants born to smoking mothers have an abnormal respiratory drive and a blunted ventilatory response to hypoxia.

Sixty-four healthy infants, aged 2 to 24 months, were classified into smoking (n = 19) or non-smoking (n = 45) groups based on maternal smoking habits. Resting ventilation, lung function, and mouth pressure 100 milliseconds after an airway occlusion at the onset of inspiration (P(0.1 )) were measured. The ventilatory response to hypoxia was assessed in 15 infants (6 in the smoking group and 9 in the non-smoking group) while breathing 14% oxygen.

Respiratory drive (P(0.1 ) = 4.9 +/- 1.3 cm H(2 )O) was lower in infants in the smoking group compared with those in the non-smoking group (P(0.1 ) = 5.9 +/- 1.2 cm H(2 )O) (P <.05). The time to peak tidal expiratory flow (tPTEF) was also shorter (0.25 +/- 0.04 seconds vs 0.32 +/- 0.09 seconds, P <.05). Infants born to non-smoking mothers showed a significant ventilatory response to hypoxia and a 24.6% increase in P(0.1 ). Infants in the smoking group showed a blunted ventilatory response to hypoxia and no increase in P(0.1 ). A dose-response relationship existed between the number of cigarettes smoked by the mother (0, 1 to 10, >10 per day) and the results for P(0.1 ) and tPTEF. Paternal smoking had no influence on the infant's resting ventilation, respiratory drive, or ventilatory response to hypoxia.

Infants born to smoking mothers have a reduced drive to breathe and a blunted ventilatory response to hypoxia. These findings may contribute to the increased risk of sudden infant death syndrome in these infants.