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Maternal smoking during pregnancy. Effects on lung function during the first 18 months of life
I B Tager1, L Ngo, J P Hanrahan
1Division of Public Health Biology and Epidemiology, School of Public Health, University of California Berkeley 94720-7360, USA.
Insights
Maternal smoking during pregnancy significantly reduced infant lung function, particularly in female infants. Postnatal smoke exposure showed no significant impact on lung development.
Area of Science:
- Pediatric Respiratory Medicine
- Environmental Health
- Developmental Pediatrics
Background:
- Maternal smoking during pregnancy is a known risk factor for adverse respiratory outcomes in children.
- Understanding the specific impact on early lung function growth is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the effects of maternal smoking during pregnancy on infant lung function growth up to 18 months.
- To compare the impact of prenatal versus postnatal environmental tobacco smoke exposure.
Main Methods:
- Longitudinal study of 159 infants, assessing pulmonary function via flow-volume curves and helium dilution FRC at multiple time points.
- Maternal smoking assessed through questionnaires and urine cotinine levels.
- Statistical analysis controlled for infant growth parameters (length).
Main Results:
- Maternal smoking during pregnancy was associated with reduced functional residual capacity (FRC) and flow at FRC (VFRC).
- The negative impact was more pronounced in female infants, with a predicted 16% VFRC reduction at 1 year versus 5% in males.
- Postnatal environmental tobacco smoke exposure did not show a significant association with reduced lung function.
Conclusions:
- Maternal smoking during pregnancy has a significant detrimental effect on early infant lung function development.
- Prenatal exposure appears to be a more critical factor than postnatal exposure for these observed effects.
- Findings highlight the importance of smoking cessation programs for pregnant women to protect infant respiratory health.
Abstract:
The present investigation evaluated the effects of maternal smoking during pregnancy on the growth of lung function during the first 18 mo of life in 159 infants who were part of a longitudinal study of the effects of maternal smoking on respiratory health. Infant pulmonary function was assessed at 2 to 6 wk of age and at 4 to 6, 9 to 12, and 15 to 18 mo of age by partial expiratory flow-volume curves and helium dilution FRC. Maternal smoking was assessed by standard questionnaire and urine cotinine measurements. Maternal smoking during pregnancy was associated with a reduction of 9.4 +/- 4.3 ml (p = 0.029) for FRC and 33 +/- 12.3 ml/s (p = 0.008) reduction for flow at FRC (VFRC) after controlling for the effects of growth (length). The effect of maternal smoking was greater for female infants than for male infants. At 1 yr female infants exposed in utero were predicted to have a 16% reduction in VFRC compared with 5% for male infants. No sex difference was seen for FRC or VFRC/FRC. Exposure to environmental tobacco smoke in the postnatal period was not significantly related to reduced FRC or VFRC. These data provide further evidence that maternal smoking during pregnancy may play a greater role than postnatal and childhood exposure on the observed effects on lung function in children.