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Cited by 51Prenatal Substance Exposure EffectsSmoking Behavior and CessationMaternal and Neonatal Healthcare

Iqmik: a form of smokeless tobacco used by pregnant Alaska natives: nicotine exposure in their neonates

Hurt, Richard D, Renner, Caroline C, Patten, Christi A, Ebbert, Jon O, Offord, Kenneth P, Schroeder, Darrell R, Enoch, Carrie C, Gill, Leigh +2 more·2005·The Journal of Maternal-Fetal & Neonatal Medicine
DOI 10.1080/14767050500123731
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Abstract

OBJECTIVE: To determine the concentration of nicotine and cotinine in maternal blood and neonatal cord blood among pregnant Alaska Native women and to assess the neonates for neurobehavioral effects. METHODS: In a nonrandomized, clinical observational pilot trial, 60 pregnant Alaska Native women were enrolled for assessment of Iqmik (a mixture of leaf tobacco and ash) and other tobacco use during pregnancy and at delivery. Neonatal cord blood, nicotine and cotinine concentrations were obtained, and neonatal neurobehavioral effects were assessed using the Lipsitz scale. RESULTS: At delivery, there were 22 subjects who reported using only Iqmik, and 10 who used other tobacco products. Subjects who reported using only Iqmik prior to delivery had higher concentrations of cotinine (167+/-116 vs. 81+/-100) in maternal blood (rank sum test, p=0.036) and higher concentrations of nicotine (8.4+/-7.3 vs. 4.4+/-5.1, p=0.048) and cotinine (153+/-115 vs. 70+/-95, p=0.048) in cord blood compared to subjects who reported using other tobacco products. Neurobehavioral signs as assessed by the Lipsitz score were increased in neonates born to mothers using only Iqmik (3.7+/-1.8, p=0.011), or to mothers using other tobacco products (3.4+/-1.4, p=0.034) compared to neonates born to women who reported no tobacco use (1.8+/-1.4). CONCLUSIONS: Mothers who use Iqmik and their neonates have higher cotinine concentrations compared to mothers who use cigarettes and/or other forms of tobacco. Neurobehavioral signs occur in neonates born to women who use Iqmik but also in neonates born to mothers who use other forms of tobacco during pregnancy.

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  • Tobacco-exposed neonates show more abstinence/withdrawal signs, hypertonicity, irritability, and excitability, with a dose-response relationship to nicotine exposure.

    “studies of the immediate neonatal period (postnatal days 1-5) revealed increased signs of abstinence/withdrawal, hypertonicity, irritability, and excitability in tobacco-exposed neonates, with a clear dose-response relationship to nicotine exposure.”

    From Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products (2017) · cites this paper as [124]

  • Effects of maternal smoking/nicotine exposure on offspring neurobehavior and signs of abstinence in the immediate newborn period (up to postnatal day 5) have been corroborated by two additional studies.

    “Effects of maternal smoking/nicotine exposure on offspring neurobehavior and signs of abstinence in the immediate newborn period (up to postnatal day 5) have been corroborated by two additional studies.”

    From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [14]

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Authors
Hurt, R. D., Renner, C. C., Patten, C. A., Ebbert, J. O., Offord, K. P., Schroeder, D. R., Enoch, C. C., Gill, L., Angstman, S. E., & Moyer, T. P.
Affiliations
  • Mayo Clinic (US)
  • Yukon Kuskokwim Health Corporation (US)
Corresponding author
Hurt, Richard D
ORCID
Venue
The Journal of Maternal-Fetal & Neonatal Medicine
Publisher
Informa UK Limited
Published
2005-04-01
Volume
17
Issue
4
Pages
281-289
ISSN
  • 1476-4954 (ISSN-L)
  • 1476-7058
DOI
10.1080/14767050500123731
OpenAlex
W2119187662
Cited by
51
References
20
Citations by year
2022: 4 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 2 · 2014: 4 · 2013: 6 · 2012: 4
FWCI
2.02
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (UO1 CA86098, U01CA086098)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
smokeless tobacco, smoking during pregnancy, nicotine exposure, cotinine, maternal blood, umbilical cord blood, Alaska Native women, cigarette smoking
MeSH terms
Adult, Alaska, Cotinine, Inuit, Feasibility Studies, Female, Fetal Blood, Humans, Infant, Newborn, Infant, Newborn, Diseases, Nervous System Diseases, Nicotine, Pilot Projects, Pregnancy, Pregnancy Outcome, Prenatal Exposure Delayed Effects, Smoking, Tobacco Use Disorder, Tobacco, Smokeless

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