Pregnancy outcome in North American women. II. Effects of diet, cigarette smoking, stress, and weight gain on placentas, and on neonatal physical and behavioral characteristics

Abstract

This study evaulated the effects of diet, weight gain (low = LWG, less than or equal to 15 lb; adequate greater than 15 lb), smoking, and stress on the pregnancy outcomes of 60 women. LWG mothers, compared to adequate weight gain, had lower calorie intakes, shorter gestations (0.5 wk, Dubowitz) smaller placentas (345 +/- 65 versus 373 +/- 75 g), and infants with lower birth weight 2640 +/- 329 versus 3192 +/- 307 g), ponderal indices (2.37 versus 2.62), and growth rates. Mothers who smoked had increased calorie intake, but showed no alterations in gestational age of infants or placenta weights. Infants of smokers weighed less than those of nonsmokers (2875 +/- 522 versus 309 +/- 511 g), but had a normal ponderal index. LWG or smoking were associated with impaired motor performance, visual habituation and orientation, and reflexes. Smoking adversely affected auditory habituation and orientation, and autonomic regulation. LWG and smoking have significant, but separate, detrimental effects on pregnancy outcome.

Does In Utero Exposure to Heavy Maternal Smoking Induce Nicotine Withdrawal Symptoms in Neonates?

“…Conflicting data about nicotine withdrawal in newborns are found in previous studies. Newborns of smoking mothers were shown to have impaired performances at days 1 and 2 when compared with newborns of nonsmoking mothers (14). However, these findings were not supported by biologic monitoring of nicotine exposure in mothers and their offspring.…”

Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus

“…The AAP clinical report on neonatal drug withdrawal contains in-depth information on neonatal drug withdrawal, including treatment options. 155 Neurobehavior Abnormalities of newborn neurobehavior, including impaired orientation and autonomic regulation 156 and abnormalities of muscle tone, 144,147,157 have been identified in a number of prenatal nicotine exposure studies. Poor habituation and low levels of arousal along with motor abnormalities have been identified in women who drank alcohol heavily during their pregnancy.…”

The association between prenatal exposure to cigarettes and infant and maternal negative affect

“…In addition, a growing body of research has documented an association between prenatal exposure to cigarettes and deficits in affective behaviors and regulation. Exposed infants have been found to show deficits in arousal and attention throughout the first year of life (Franco et al, 1999;Franco et al, 2000;Fried & Makin, 1987;Jacobson, Fein, Jacobson, Schwartz & Dowler, 1984;Picone, Allen, Olsen, & Ferris, 1982;Saxton, 1978;Schuetze & Eiden, 2006;Schuetze & Zeskind, 2001;Streissguth, Barr, & Martin, 1983). Studies have also found differences in affective behaviors among exposed infants as compared to nonexposed infants as early as the neonatal period and persisting into childhood.…”