Does in utero exposure to heavy maternal smoking induce nicotine withdrawal symptoms in neonates?
Abstract
Maternal drug use during pregnancy is associated with fetal passive addiction and neonatal withdrawal syndrome. Cigarette smoking-highly prevalent during pregnancy-is associated with addiction and withdrawal syndrome in adults. We conducted a prospective, two-group parallel study on 17 consecutive newborns of heavy-smoking mothers and 16 newborns of nonsmoking, unexposed mothers (controls). Neurologic examinations were repeated at days 1, 2, and 5. Finnegan withdrawal score was assessed every 3 h during their first 4 d. Newborns of smoking mothers had significant levels of cotinine in the cord blood (85.8 +/- 3.4 ng/mL), whereas none of the controls had detectable levels. Similar findings were observed with urinary cotinine concentrations in the newborns (483.1 +/- 2.5 microg/g creatinine versus 43.6 +/- 1.5 microg/g creatinine; p = 0.0001). Neurologic scores were significantly lower in newborns of smokers than in control infants at days 1 (22.3 +/- 2.3 versus 26.5 +/- 1.1; p = 0.0001), 2 (22.4 +/- 3.3 versus 26.3 +/- 1.6; p = 0.0002), and 5 (24.3 +/- 2.1 versus 26.5 +/- 1.5; p = 0.002). Neurologic scores improved significantly from day 1 to 5 in newborns of smokers (p = 0.05), reaching values closer to control infants. Withdrawal scores were higher in newborns of smokers than in control infants at days 1 (4.5 +/- 1.1 versus 3.2 +/- 1.4; p = 0.05), 2 (4.7 +/- 1.7 versus 3.1 +/- 1.1; p = 0.002), and 4 (4.7 +/- 2.1 versus 2.9 +/- 1.4; p = 0.007). Significant correlations were observed between markers of nicotine exposure and neurologic-and withdrawal scores. We conclude that withdrawal symptoms occur in newborns exposed to heavy maternal smoking 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 [126]
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 [13]
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Vélez, M. L., & Jansson, L. M. (2014) · Springer eBooks · doi:10.1007/978-88-470-5322-9_100 · Cited by 2 · see citing works
Krishnamoorthy, D., & Kaminer, Y. (2020) · Cannabis · doi:10.26828/cannabis.2020.01.002 · Cited by 2 · see citing works
(2025) · American Academy of PediatricsItasca, IL eBooks · doi:10.1542/9781610027700-ch3 · Cited by 1 · see citing works
Quels sont les outils diagnostiques chez le nouveau-né de l’exposition anténatale au tabagisme ?
Burguet, A. (2005) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/s0368-2315(05)82995-3 · Cited by 1 · see citing works
“Bien qu’il soit moins intense que le syndrome de sevrage aux opiacés, le syndrome de sevrage existe et quantifiable sur un score de Finnegan ou Lipsitz [34, 35].”
BackgroundPragmatic Strategies to Help Pregnant Smokers Quit
Mbbs, P. E. S. E., Ragonetti, R. O. D., & Pipe, A. (2007) · Cited by 1 · see citing works
Smoking during pregnancy and fetal brain development
Ekblad, M. O. (2013) · UTUPub (University of Turku) · Cited by 1 · see citing works
Wallen, L. D., & Gleason, C. A. (2018) · Avery's Diseases of the Newborn · doi:10.1016/b978-0-323-40139-5.00013-9 · Cited by 1 · see citing works
Les TSO chez la femme enceinte : effets sur la grossesse et l’enfant
Kueny, L. (2015) · HAL
Wallen, L. D., & Gleason, C. A. (2011) · Avery's Diseases of the Newborn · doi:10.1016/b978-1-4377-0134-0.10012-5
Stabler, M. E. (2015) · doi:10.33915/etd.6711
“[17, 22] Although a lack of literature exists regarding NAS and non-opioid exposures, especially among a general substance using maternal population, NAS symptomatology has been linked to alcohol [23-25], nicotine [26-29], cocaine[30-32],”
BackgroundPrenatal Drug Use: Neonatal Effects and the Neonatal Withdrawal Syndrome
Ostrea, E. M., Cortez, J. M., Alviedo, N. J. B., Bañadera, F. D. P., Jesus, L. C. D., & Cheng, C. T. (2016) · doi:10.9954/gb104
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Prenatal Drug Use: Neonatal Effects and the Neonatal Withdrawal Syndrome
Ostrea, E. M., Cortez, J. M., Alviedo, N. J. B., Bañadera, F. D. P., Jesus, L. C. D., & Cheng, C. T. (2020) · American Academy of PediatricsItasca, IL eBooks · doi:10.1542/9781610022255-29
Polycyclic aromatic hydrocarbons in maternal and cord blood plasma.
Radmacher, P. G. (2007) · doi:10.18297/etd/1174
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- Authors
- Godding, V., Bonnier, C., Fiasse, L., Michel, M., Longueville, E., Lebecque, P., Robert, A., & Galanti, L.
- Affiliations
- Cliniques Universitaires Saint-Luc (BE)
- Clinique Saint Pierre (BE)
- UCLouvain (BE)
- Venue
- Pediatric Research
- Published
- 2004-04
- Volume
- 55
- Issue
- 4
- Pages
- 645-651
- ISSN
- 0031-3998 (ISSN-L)
- 1530-0447
- OpenAlex
- W1995794600
- Cited by
- 71
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 4 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pediatric Research (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (submittedVersion)
- 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
- smoking during pregnancy, prenatal nicotine exposure, neonatal abstinence syndrome, cotinine, urinary cotinine
- MeSH terms
- Adult, Cotinine, Female, Fetal Blood, Humans, Infant, Infant, Newborn, Maternal-Fetal Exchange, Nervous System Diseases, Nicotine, Pregnancy, Prenatal Exposure Delayed Effects, Smoking, Statistics as Topic, Substance Withdrawal Syndrome, Tobacco Use Disorder, Maternal Exposure
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