Neonatal Urinary Cotinine Correlates With Behavioral Alterations in Newborns Prenatally Exposed to Tobacco Smoke

Abstract

Altered behavior due to prenatal smoke exposure was examined in 25 neonates born from smoking mothers who consumed at least 5 cigarettes/d during the entire gestation. Data were compared with 25 matched neonates born from nonsmoking mothers. Neonatal behavior was evaluated using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS). Antenatal exposure to tobacco smoke at the end of the pregnancy was determined by measurement of urinary cotinine. Newborns from smoking mothers showed significant lower scores in various BNBAS items compared with neonates from nonsmoking mothers. A strong correlation was observed between infant irritability and urinary cotinine in newborns from smoker and nonsmoking mothers and with number of daily smoked cigarettes and maternal nicotine daily intake of infants exposed to active maternal smoking. Linear regression analysis showed that urinary cotinine was the best predictor of infant irritability (r 2 ϭ 0.727). The latter was also associated to the neonate's low level of attention and poor response to inanimate auditory stimuli. Among infants from nonsmoking mothers, paternal smoking significantly correlated with infant urinary cotinine and infant irritability, being also the best predictor of irritability (r 2 ϭ 0.364). Neonatal behavior can be significantly altered in a dose-dependent manner even after modest prenatal exposure to tobacco smoke.

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

“…There is also a greater likelihood of exposed infants to be admitted into the neonatal intensive care unit relative to unexposed controls (Adams et al, 2002). Newborns exposed in utero to nicotine are more irritable and have poorer attention than unexposed infants, and they exhibit hypertonicity, increased tremors and startle responses, and deficient speech processing as well (Espy et al, 2011;Key et al, 2007;Mansi et al, 2007;Reijneveld et al, 2002;Stroud et al, 2009a). Within the first month of life, exposed infants show signs of poorer self-regulation and require more handling by caregivers (Stroud et al, 2009b).…”

“…Within the first month of life, exposed infants show signs of poorer self-regulation and require more handling by caregivers (Stroud et al, 2009b). Newborns also demonstrate an attenuated response to auditory stimuli, an effect that can contribute to language and learning impairments later in life (Kable et al, 2009;Mansi et al, 2007).…”

Determining the impact of prenatal tobacco exposure on self-regulation at 6 months.

“…Numerous studies spanning several decades have found differences in arousal, attention, reaction to stress, and soothability between tobacco-exposed (TE) and non-exposed (NE) neonates (Espy et al, 2011; Jacobson, Fein, Jacobson, Schwartz, & Dowler, 1984; Mansi et al, 2007; Stroud et al, 2009). In contrast, there is a relative dearth of research examining the effects of PTE on infant self-regulation beyond the first month of life.…”

Cotinine en pédiatrie et en santé au travail

“…[29] ont démontré de façon tout à fait claire, dans une étude incluant 50 nouveaunés, que la cotinurie mesurée à la naissance était prédictive des modifications de comportement à type d'irritabilité, de troubles de l'attention ou de difficultés de réponses à un stimulus, observées plus tard chez ces nourrissons.…”