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Respiratory function among preterm infants whose mothers smoked during pregnancy
A F Hoo1, M Henschen, C Dezateux
1Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH, UK.
American Journal of Respiratory and Critical Care Medicine
|September 10, 1998
Summary
Prenatal tobacco exposure impairs infant lung development, even in early preterm births. This study shows reduced respiratory function in infants exposed to smoking in utero, indicating effects beyond the final weeks of pregnancy.
Area of Science:
- Neonatal Medicine
- Respiratory Physiology
- Environmental Health
Background:
- Prenatal exposure to tobacco smoke is a known risk factor for adverse respiratory outcomes in newborns.
- The specific timing of vulnerability during gestation for these effects remains an area of investigation.
Purpose of the Study:
- To investigate whether the detrimental effects of prenatal tobacco exposure on lung development are confined to the later stages of pregnancy.
- To compare respiratory function in preterm infants based on maternal smoking status during gestation.
Main Methods:
- Respiratory function, including maximal forced expiratory flow (Vmax FRC) and time to peak tidal expiratory flow (TPTEF:TE), was measured in 108 preterm infants before hospital discharge.
- Infant urinary cotinine levels were used to confirm prenatal tobacco exposure.
- Statistical analyses adjusted for confounding factors such as sex, ethnicity, body size, postnatal age, and socioeconomic status.
Main Results:
- Infants exposed to tobacco in utero exhibited significantly lower TPTEF:TE compared to unexposed infants (p <= 0.02).
- A trend towards reduced Vmax FRC was observed in exposed infants (p = 0.07).
- The diminished TPTEF:TE in exposed infants persisted after adjusting for multiple confounding variables (p < 0.05).
Conclusions:
- Adverse effects on respiratory function due to prenatal tobacco exposure are evident in preterm infants born as early as 7 weeks before their due date.
- These findings suggest that the negative impact of maternal smoking on lung development is not limited to the final weeks of gestation.
- Prenatal smoke exposure poses a risk to respiratory health throughout a significant portion of fetal lung development.