Arch Dis Child Fetal Neonatal Ed 1999;80:F8-F14 ( January )

Effects of smoking in pregnancy on neonatal lung function

Anthony D Milner, Michael J Marsh, Dorothea M Ingram, Grenville F Fox, Chakraphan Susiva

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

AIMSTo 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.
METHODSLung 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.
RESULTSSmoking 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 (C_rs). This effect remained significant after relating C_rs to weight and lung volume. Regression analyses showed that the C_rs association was limited to the boys. Smoking was associated with a small but significant reduction in respiratory system conductance (G_rs) (single breath occlusion technique) and total pulmonary conductance (G_p). These associations were limited to girls.
CONCLUSIONSSmoking in pregnancy reduces static compliance in boys and conductance in girls. There was no evidence that maternal smoking adversely affected fetal lung growth.

Key messages  Smoking during pregnancy has an adverse effect on birthweight, length, head and chest circumference  The lungs of boys but not girls infants born to smoking mothers have reduced compliance  The lungs of girls but not boys born to smoking mothers have increased airways resistance, possibly due to the growth suppression effect  Pulmonary hypoplasia is not responsible for the increase in respiratory symptoms associated with antenatal smoking

Keywords: maternal smoking; lung function; cotinine

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© 1999 by Archives of Disease in Childhood
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