Smoking in pregnancy: a risk factor for adverse neurodevelopmental outcome in preterm infants?
OBJECTIVE
To assess whether smoking in pregnancy influences neurodevelopmental outcome at 2-years of age in preterm infants with a gestational age <32 weeks.


METHODS
Between January 2003 and December 2005 we prospectively enrolled 181 infants born alive between 23 and 32 weeks of gestation; 142 infants (78.5%) completed the follow-up visit. The association between candidate risk factors and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analysed by means of logistic regression analysis.


RESULTS
Low maternal age, smoking in pregnancy, low gestational age, low birth weight, small for gestational age, chronic lung disease, intracerebral haemorrhage, periventricular leucomalacia, and retinopathy of prematurity (stages 3 and 4) all were associated with an increased risk for delayed development (p < 0.05, each). Smoking in pregnancy, small for gestational age and chronic lung disease maintained significance in a multivariable analysis.


CONCLUSIONS
Smoking in pregnancy emerged as a risk predictor for adverse neurodevelopmental outcome in our study. Strategies to reduce smoking in pregnancy should be further endorsed.
Kiechl-Kohlendorfer
U
U
Department of Paediatrics, Division of Neonatology, Neuropaediatrics and Metabolic Disorders, Innsbruck Medical University, Innsbruck, Austria. ursula.kohlendorfer@i-med.ac.at
Ralser
E
E
Pupp Peglow
U
U
Reiter
G
G
Griesmaier
E
E
Trawöger
R
R
D000328:Adult; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology*; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D055370:Lung Injury; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D055815:Young Adult