title: Does in utero exposure to heavy maternal smoking induce nicotine withdrawal symptoms in neonates?
abstract: Maternal drug use during pregnancy is associated with fetal passive addiction and neonatal withdrawal syndrome. Cigarette smoking-highly prevalent during pregnancy-is associated with addiction and withdrawal syndrome in adults. We conducted a prospective, two-group parallel study on 17 consecutive newborns of heavy-smoking mothers and 16 newborns of nonsmoking, unexposed mothers (controls). Neurologic examinations were repeated at days 1, 2, and 5. Finnegan withdrawal score was assessed every 3 h during their first 4 d. Newborns of smoking mothers had significant levels of cotinine in the cord blood (85.8 +/- 3.4 ng/mL), whereas none of the controls had detectable levels. Similar findings were observed with urinary cotinine concentrations in the newborns (483.1 +/- 2.5 microg/g creatinine versus 43.6 +/- 1.5 microg/g creatinine; p = 0.0001). Neurologic scores were significantly lower in newborns of smokers than in control infants at days 1 (22.3 +/- 2.3 versus 26.5 +/- 1.1; p = 0.0001), 2 (22.4 +/- 3.3 versus 26.3 +/- 1.6; p = 0.0002), and 5 (24.3 +/- 2.1 versus 26.5 +/- 1.5; p = 0.002). Neurologic scores improved significantly from day 1 to 5 in newborns of smokers (p = 0.05), reaching values closer to control infants. Withdrawal scores were higher in newborns of smokers than in control infants at days 1 (4.5 +/- 1.1 versus 3.2 +/- 1.4; p = 0.05), 2 (4.7 +/- 1.7 versus 3.1 +/- 1.1; p = 0.002), and 4 (4.7 +/- 2.1 versus 2.9 +/- 1.4; p = 0.007). Significant correlations were observed between markers of nicotine exposure and neurologic-and withdrawal scores. We conclude that withdrawal symptoms occur in newborns exposed to heavy maternal smoking during pregnancy.
authors.affiliation: Pediatric Pulmonology, Cliniques Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium. godding@mexp.ucl.ac.be
authors.forename: Veronique
authors.initials: V
authors.lastname: Godding
authors.forename: Christine
authors.initials: C
authors.lastname: Bonnier
authors.forename: Leon
authors.initials: L
authors.lastname: Fiasse
authors.forename: Marianne
authors.initials: M
authors.lastname: Michel
authors.forename: Etienne
authors.initials: E
authors.lastname: Longueville
authors.forename: Patrick
authors.initials: P
authors.lastname: Lebecque
authors.forename: Annie
authors.initials: A
authors.lastname: Robert
authors.forename: Laurence
authors.initials: L
authors.lastname: Galanti
mesh_terms: D000328:Adult; D003367:Cotinine / Q000097:blood / Q000652:urine; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018811:Maternal Exposure; D008431:Maternal-Fetal Exchange; D009422:Nervous System Diseases / Q000209:etiology; D009538:Nicotine / Q000378:metabolism; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012907:Smoking / Q000009:adverse effects*; D013223:Statistics as Topic; D013375:Substance Withdrawal Syndrome; D014029:Tobacco Use Disorder
chemical_list: D009538:Nicotine; D003367:Cotinine