title: 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) = 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) = 0.364). Neonatal behavior can be significantly altered in a dose-dependent manner even after modest prenatal exposure to tobacco smoke.
authors.affiliation: Department of Pediatrics, Division of Neonatology, University "Federico II", 80010 Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Mansi
authors.forename: Francesco
authors.initials: F
authors.lastname: Raimondi
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.forename: Letizia
authors.initials: L
authors.lastname: Capasso
authors.forename: Micaela
authors.initials: M
authors.lastname: Sarno
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Zuccaro
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.forename: Oscar
authors.initials: O
authors.lastname: Garcia-Algar
authors.forename: Alfonso
authors.initials: A
authors.lastname: Romano
authors.forename: Roberto
authors.initials: R
authors.lastname: Paludetto
mesh_terms: D015415:Biomarkers / Q000652:urine; D003367:Cotinine / Q000652:urine*; D005260:Female; D006801:Humans; D018730:Infant Behavior; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D012907:Smoking
chemical_list: D015415:Biomarkers; D003367:Cotinine