Antenatal substance misuse and smoking and newborn hypoxic challenge response.
OBJECTIVE
Infants of smoking (S) and substance misusing (SM) mothers have an increased risk of sudden infant death syndrome. The aim of this study was to test the hypothesis that infants of SM or S mothers compared with infants of non-SM, non-smoking mothers (controls) would have a poorer ventilatory response to hypoxia, which was particularly marked in the SM infants.


METHODS
Physiological study.


METHODS
Tertiary perinatal centre.


METHODS
21 SM; 21 S and 19 control infants. Infants were assessed before maternity/neonatal unit discharge.


METHODS
Maternal and infant urine samples were tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine and benzodiazepines.


METHODS
During quiet sleep, the infants were switched from breathing room air to 15% oxygen and changes in minute volume were assessed.


RESULTS
The SM infants had a greater mean increase (p=0.028, p=0.034, respectively) and a greater magnitude of decline (p<0.001, p=0.018, respectively) in minute volume than the S infants and the controls. The rate of decline in minute volume was greater in the SM infants (p=0.008) and the S infants (p=0.011) compared with the controls.


CONCLUSIONS
Antenatal substance misuse and smoking affect the infant's ventilatory response to a hypoxic challenge.
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Kamal
K
Ali
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Thomas
T
Rossor
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Ravindra
R
Bhat
Addiction Sciences Unit, King's College London, London, UK.
Kim
K
Wolff
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Simon
S
Hannam
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Gerrard F
GF
Rafferty
National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK Division of Health and Social Care Research, King's College London, London, UK.
Janet L
JL
Peacock
Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
Anne
A
Greenough
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D007231:Infant, Newborn; D008176:Lung Volume Measurements; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D012890:Sleep; D012907:Smoking / Q000503:physiopathology*; D019966:Substance-Related Disorders / Q000503:physiopathology*; D055815:Young Adult
D010100:Oxygen
Sudden infant death syndrome; in utero nicotine exposure; minute volume