Maternal tobacco smoke exposure and persistent pulmonary hypertension of the newborn.
We propose that in utero exposure to tobacco smoke products places a newborn at risk for persistent pulmonary hypertension of the newborn (PPHN). To test this hypothesis, infants with PPHN were identified. Healthy newborns of similar ethnicity were identified as a comparison group. Cord blood cotinine concentrations and maternal questionnaires were obtained. The number of women exposed to tobacco smoke in each group ascertained by questionnaire was borderline significantly different (38.7% vs. 20.5%; p = 0.080). However, more PPHN infants had detectable cotinine in their cord blood (64.5% vs. 28.2%; p = 0.002), and the median cotinine concentrations were significantly higher (5.2 ng/ml vs. 2 ng/ml; p = 0.051) than the comparison infants. Among infants delivered to nonsmoking women, more PPHN infants had detectable cotinine (50% vs. 19%; p = 0.015), and the cotinine concentrations were higher (3.5 ng/ml vs. 1.65 ng/ml; p = 0.022) than the comparison group. We conclude that active and passive smoking during pregnancy is a risk factor for PPHN. Therefore, we recommend that pregnant women cease smoking and avoid environmental tobacco smoke. Key words. cotinine, newborns, passive, persistent pulmonary hypertension, smoking, tobacco smoke pollution.
Bearer
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Case Western Reserve University, Cleveland, OH 44106-6010, USA.
Emerson
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O'Riordan
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Roitman
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Shackleton
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D000328:Adult; D002140:California; D016022:Case-Control Studies; D003367:Cotinine / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure; D009538:Nicotine / Q000009:adverse effects*; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000453:epidemiology*; D011247:Pregnancy; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
D014028:Tobacco Smoke Pollution; D009538:Nicotine; D003367:Cotinine