Traditionally, nicotine from second hand smoke (SHS), active or passive, has been considered the most prevalent substance of abuse used during pregnancy in industrialized countries. Exposure to environmental tobacco smoke (ETS) is associated with a variety of health effects, including lung cancer and cardiovascular diseases. Tobacco is also a major burden to people who do not smoke. As developing individuals, newborns and children are particularly vulnerable to the negative effects of SHS. In particular, prenatal ETS has adverse consequences during the entire childhood causing an increased risk of abortion, low birth weight, prematurity and/or nicotine withdrawal syndrome. Over the last years, a decreasing trend in smoking habits during pregnancy has occurred, along with the implementation of laws requiring smoke free public and working places. The decrease in the incidence of prenatal tobacco exposure has usually been assessed using maternal questionnaires. In order to diminish bias in self-reporting, objective biomarkers have been developed to evaluate this exposure. The measurement of nicotine and its main metabolite, cotinine, in non-conventional matrices such as cord blood, breast milk, hair or meconium can be used as a non-invasive measurement of prenatal SMS in newborns. The aim of this review is to highlight the prevalence of ETS (prenatal and postnatal) using biomarkers in non-conventional matrices before and after the implementation of smoke free policies and health effects related to this exposure during foetal and/or postnatal life.

Background: Nicotine from maternal active smoking or environmental tobacco smoke (ETS) is still the most prevalent substance of abuse during pregnancy in industrialized countries. The negative effects of exposure to tobacco smoke on foetus development have been widely described: impaired foetal growth and increased risks for gestational and perinatal outcomes. Objective: The aim of this review was to provide an overview on prenatal nicotine exposure and its behavioral and neurodevelopmental deleterious effects in new-borns and children. Method: We searched MEDLINE and EMBASE for articles catalogued between 1992 and 2015. We identified relevant published studies that assessed the association between maternal smoking and neurodevelopment deleterious effects in offspring. From 33 citations, a total of 17 studies were included. Results: Literature definitively supports a strong association between exposed new-borns and signs of stress and neonatal withdrawal symptoms. Furthermore, an association between exposure to nicotine and attention-deficit/ hyperactivity disorder (ADHD) in children has been reported in many studies, as well as a wide range of externalizing outcomes, especially rule-breaking and aggressive behaviour, with increased risk of conduct disorders and crime. Conclusions: It is necessary to follow up children with prenatal exposure to ETS in order to detect neurodevelopment effects during childhood. We also recommend the implementation of campaigns to avoid smoking in pregnant women, with structured medical advice and protection of pregnant women and children from ETS.

No abstract