Developmental consequences of prenatal tobacco exposure
- PMID: 19532034
- PMCID: PMC2745235
- DOI: 10.1097/WCO.0b013e328326f6dc
Developmental consequences of prenatal tobacco exposure
Abstract
Purpose of review: This paper reviews results from published, in press, and conference proceedings from 2007 and 2008 that link in-utero tobacco exposure to neurodevelopmental outcomes in exposed offspring.
Recent findings: Prenatal tobacco exposure (PTE) affected speech processing, levels of irritability and hypertonicity, attention levels, ability to self-regulate, need to be handled, and response to novelty preference in infants. In early childhood, PTE effects were mostly behavioral outcomes including activity and inattention and externalizing behaviors, including conduct disorder and antisocial behavior. In adolescents, PTE predicted increased attention deficit hyperactivity disorder, modulation of the cerebral cortex and white matter structure, and nicotine addiction. Several studies found moderating effects with PTE and genetic susceptibilities including dopamine transporter, serotonergic synaptic function, and monomine oxidase pathways. Other studies suggested that environmental and genetic factors might be more important than the direct teratological effects of PTE.
Summary: The majority of studies reviewed were prospective and tobacco exposure was quantified biologically. Most demonstrated a direct association between PTE and neurodevelopmental outcomes. More work is needed to examine multifactorial influences. Effects of PTE on the offspring appear to be moderated by genetic variability, neurobehavioral disinhibition, and sex.
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Mansi G, Raimondi F, Pichini S, et al. Neonatal urinary cotinine correlates with behavioral alterations in newborns prenatally exposed to tobacco smoke. Pediatr Res. 2007;61:257–261.. Neonatal irritability was strongly correlated with maternal smoking during pregnancy and from paternal smoking around nonsmoking mothers as indicated by neonatal urine cotinine levels. Neonatal behavior was significantly altered in a dose–response manner even after modest exposure to tobacco smoke.
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