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Children's
Respiratory Unit, Department of Paediatrics, United
Medical and Dental School, St Thomas's Hospital, London SEl
7EH
Correspondence to: Professor A D Milner.
Accepted 11 July
1998
AIMS
To assess the effects of smoking during
pregnancy on lung mechanics and lung volumes in the immediate neonatal
period, before infants are exposed to passive smoking.
METHODS
Lung function tests were carried out within
72 hours of delivery in infants born to 100 non-smoking and 189 smoking
mothers. Lung growth was assessed by plethysmography and lung mechanics using the single breath occlusion technique and oesophageal balloon/ pneumotachography. Antenatal maternal serum cotinine values were obtained from 133 mothers.
RESULTS
Smoking was associated with a
significant reduction in birthweight (mean 256 g, 95% CI 0.164 to
0.392), and length (mean 1.26 cm, 95% CI 0.48 to 2.00). Lung volume
was not reduced when related to weight. Smoking was associated with a
highly significant reduction in static compliance (Crs).
This effect remained significant after relating Crs to
weight and lung volume. Regression analyses showed that the
Crs association was limited to the boys. Smoking was associated with a small but significant reduction in respiratory system
conductance (Grs) (single breath occlusion technique) and total pulmonary conductance (Gp). These associations were
limited to girls.
CONCLUSIONS
Smoking in pregnancy reduces
static compliance in boys and conductance in girls. There was no
evidence that maternal smoking adversely affected fetal lung growth.
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