Low-level prenatal exposure to nicotine and infant neurobehavior
Open accessAbstract
Objective To examine the association between prenatal exposure to nicotine from tobacco smoke and infant neurobehavior using tobacco biomarkers and a sensitive and comprehensive measure of infant neurobehavior. Study design Participants were 318 infants (206 White, 95 Black, 17 Other) and their mothers. Prenatal tobacco smoke exposure was measured twice during pregnancy and once at delivery using maternal serum cotinine. Infant neurobehavior was assessed with the NICU Network Neurobehavioral Scale at approximately 5 weeks after birth. Results Prenatal tobacco smoke exposure was significantly associated with infant neurobehavior after controlling for important covariates, but the specific behaviors associated with exposure varied by race. In White infants, higher cotinine was associated with increased arousal (p=.030) and excitability (p=.034), and decreased self-regulation (p=.010). In contrast, among Black infants, higher cotinine was associated with decreased arousal (p=.001), excitability (p=.021), and special handling required to complete the assessment (p=.003), and increased self-regulation (p=.021) and hypotonicity (p=.016). In secondary analyses, we found racial differences in the effects of postnatal exposure to second hand smoke and low-level prenatal exposure. Conclusions Low-level prenatal tobacco smoke exposure is associated with infant neurobehavior at 5 weeks of age, but the specific effects differ by race. These effects may reflect racial differences in nicotine metabolism that are similar to differences reported in adult and child studies of tobacco.
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Later in the neonatal period, tobacco-exposed infants show continued or emerging behavioral effects on self-regulation, attention, need for external soothing or handling, and arousal.
“Studies later in the neonatal period (10-30 days) found continued or emerging behavioral effects on self-regulation, attention, need for external soothing or handling, and arousal”
From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [128]
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The Neonatal Intensive Care Unit Network Neurobehavioral Scale procedures
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Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days
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“2 Newborn Neurobehavior The number of infants receiving scores on habituation and hypertonicity subscales of the NNNS were too small for meaningful interpretation (n = 29 and n = 13, respectively), so we excluded these subscales from analyses in accordance with other researchers who have used the NNNS as an outcome [1…”
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Does in utero exposure to heavy maternal smoking induce nicotine withdrawal symptoms in neonates?
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“They are also consistent with studies that have used other infant assessments reporting increased nervous system excitation [14] and decreased alertness [15] in relation to maternal smoking during pregnancy.”
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England, L. J., Aagaard, K., Bloch, M., Conway, K., Cosgrove, K., Grana, R., Gould, T. J., Hatsukami, D., Jensen, F., Kandel, D., et al. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.11.013 · Cited by 181 · see citing works
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- Authors
- Yolton, K., Khoury, J., Xu, Y., Succop, P., Lanphear, B., Bernert, J. T., & Lester, B.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- University of Cincinnati (US)
- Simon Fraser University (CA)
- Centers for Disease Control and Prevention (US)
- Brown University (US)
- Venue
- Neurotoxicology and Teratology
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 31
- Issue
- 6
- Pages
- 356-363
- ISSN
- 0892-0362 (ISSN-L)
- PMC
- PMC2761996
- OpenAlex
- W2070746474
- Cited by
- 52
- References
- 9
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 1 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 2 · 2014: 6 · 2013: 4 · 2012: 5
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurotoxicology and Teratology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Environmental Health Sciences (P01 ES11261, P01ES011261)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- prenatal tobacco exposure, nicotine, infant neurobehavior, NICU Network Neurobehavioral Scale, racial differences, self-regulation, arousal, excitability, hypotonicity, passive smoking, nicotine metabolism
- MeSH terms
- Adult, Arousal, Black or African American, Cotinine, Female, Humans, Infant, Male, Maternal-Fetal Exchange, Muscle Hypotonia, Nicotine, Pregnancy, Social Control, Informal, Biomarkers, Maternal Exposure, White People
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