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Published on: October 31, 2025
Tobacco smoke in infants with bronchopulmonary dysplasia
Stéphanie Martinez1, Patricia Garcia-Meric, Véronique Millet
1Unité de pneumologie infantile, CHU Timone-Enfants, 264 rue Saint Pierre, 13385, Marseille CEDEX 5, France, stephanie.martinez2@ap-hm.fr.
Insights
Exposure to tobacco smoke, including in utero smoking (IUS) and environmental tobacco smoke (ETS), is common in preterm infants. However, this study found no significant impact on respiratory outcomes in children with bronchopulmonary dysplasia (BPD).
Area of Science:
- Pediatrics
- Neonatology
- Respiratory Medicine
Background:
- Environmental tobacco smoke (ETS) and in utero smoking (IUS) cause significant health issues in children.
- Children with bronchopulmonary dysplasia (BPD) experience more respiratory problems, potentially exacerbated by ETS and IUS.
- Preterm infants, especially those with BPD, may be at higher risk for respiratory complications due to tobacco smoke exposure.
Purpose of the Study:
- To evaluate the association between in utero smoking (IUS) and environmental tobacco smoke (ETS) and respiratory events in preterm children with and without bronchopulmonary dysplasia (BPD).
- To determine if tobacco smoke exposure influences respiratory outcomes in infants born before 35 weeks of gestational age.
Main Methods:
- A cohort of 262 preterm infants (born <35 weeks GA) were enrolled and categorized based on BPD status, matched for gestational age and birth weight.
- Respiratory data were prospectively collected during the first two years of life.
- Parental questionnaires gathered information on respiratory health, home environment, and tobacco exposure (IUS and ETS).
Main Results:
- In utero smoking (IUS) affected 12.6% of infants, and environmental tobacco smoke (ETS) affected 48.8%.
- Exposure to ETS was particularly high (67%) among BPD children receiving home oxygen therapy.
- No significant additional influence of IUS or ETS on respiratory outcomes was observed in this cohort.
Conclusions:
- Tobacco smoke exposure rates (IUS and ETS) in preterm children are comparable to the general pediatric population.
- Preterm infants with BPD who receive home oxygen therapy exhibit the highest rates of ETS exposure.
- Despite high exposure rates, IUS and ETS did not demonstrate a significant impact on the respiratory outcomes of the studied preterm children.
Unlabelled:
Exposure to tobacco smoke has been not evaluated in children with bronchopulmonary dysplasia (BPD). We evaluate the association of in utero smoking (IUS) and environmental tobacco smoke (ETS) with the respiratory events of BPD and non-BPD children. Two hundred sixty-two children born before 35 weeks of gestational age (GA) and regularly followed up in our regional network for preterms were enrolled. They were paired according to their BPD status, their gestational age and birth weight (131 children with BPD and 131 without BPD, 28 mean weeks GA; mean weight 1000 g). Respiratory data were obtained prospectively during their first 2 years of life. A complementary questionnaire was completed by the parents about their child's respiratory health at the age of 2, their home environment, and tobacco status. IUS concerned 12.6 %; ETS, 48.8 % (67 % in BPD children treated with oxygen at home). No further influence on respiratory outcome could be found by exposure to intrauterine smoke or extrauterine tobacco smoke in this patient sample.
Conclusion:
IUS and ETS exposures are as high in preterm children as in a general pediatric population. The highest exposure occurs among BPD infants treated with oxygen at home.
What Is Known:
• Environmental tobacco smoke (ETS) and in utero smoking (IUS) are responsible for many morphological, functional, and clinical changes in children. • Children with bronchopulmonary dysplasia (BPD) have more respiratory events in their first years of life than preterm children without BPB, maybe triggered by ETS and IUS. What is New: • The exposition to ETS and IUS is high in preterm children with and without BDP, as high as in a general. • Pedaitric population, particularly in children with BPD and treated with oxygen at home. • No further influence on respiratory outcome could be found by exposure to ETS or IUS in our studied population.
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