Adverse pregnancy outcomes and long-term morbidity after early fetal hypokinesia in maternal smoking pregnancies.
OBJECTIVE
The aim of this study is to evaluate perinatal outcome and subsequent morbidity and neurodevelopment in 10-year-old children with fetal hypokinesia intrauterinely verified by ultrasonography in early pregnancy as a pattern of abnormal fetal behavior due to maternal chronic smoking. This study revealed significant global fetal hypokinesia as well as head and arm hypokinesia in early pregnancy in mothers' chronic smokers (group 3-more than 20 cigarettes a day).


METHODS
This retrospective study was performed in mothers and their 10-year-old children included in the study of the effect of cigarette smoking on fetal movements in early pregnancy. Perinatal outcome was assessed according to maternal data, course, and outcome of pregnancy and delivery. Data on the long-term (10 years) development and morbidity from infancy during childhood until age 10 years were obtained from the children's medical histories and medical rehabilitation records, maternal, and paternal histories. The psycholinguistic development was estimated.


RESULTS
In group 3, there was a poor overall perinatal outcome and high rate of the bronchoconstrictive syndrome and recurrent infections, while one case of the sudden infant death syndrome. Poor school performance was recorded in five children, attention-deficit/hyperactivity disorder in four, and autism, dystonia syndrome, social maladaptation, and minimally cerebral disfunction in one child each. Retarded psycholinguistic development was found in seven children, only three of them attending speech therapy (P < 0.05).


CONCLUSIONS
Fetal hypokinesia in early pregnancy related with maternal smoking was found to correlate with poor perinatal outcome, subsequent morbidity, and developmental impairments in 10-year-old children born to mothers smoking more than 20 cigarettes a day.
Habek
Dubravko
D
Department of Obstetrics and Gynecology, School of Medicine, Zagreb University, Sveti Duh Hospital, Sveti Duh 64, 10000 Zagreb, Croatia. dubravko.habek@os.t-com.hr
Kovačević
Melita
M
D016084:Bronchoconstriction; D002648:Child; D005260:Female; D006801:Humans; D018476:Hypokinesia / Q000453:epidemiology* / Q000401:mortality; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000401:mortality; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*