Neonatal Urinary Cotinine Correlates With Behavioral Alterations in Newborns Prenatally Exposed to Tobacco Smoke
Abstract
Altered behavior due to prenatal smoke exposure was examined in 25 neonates born from smoking mothers who consumed at least 5 cigarettes/d during the entire gestation. Data were compared with 25 matched neonates born from nonsmoking mothers. Neonatal behavior was evaluated using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS). Antenatal exposure to tobacco smoke at the end of the pregnancy was determined by measurement of urinary cotinine. Newborns from smoking mothers showed significant lower scores in various BNBAS items compared with neonates from nonsmoking mothers. A strong correlation was observed between infant irritability and urinary cotinine in newborns from smoker and nonsmoking mothers and with number of daily smoked cigarettes and maternal nicotine daily intake of infants exposed to active maternal smoking. Linear regression analysis showed that urinary cotinine was the best predictor of infant irritability (r(2) = 0.727). The latter was also associated to the neonate's low level of attention and poor response to inanimate auditory stimuli. Among infants from nonsmoking mothers, paternal smoking significantly correlated with infant urinary cotinine and infant irritability, being also the best predictor of irritability (r(2) = 0.364). Neonatal behavior can be significantly altered in a dose-dependent manner even after modest prenatal exposure to tobacco smoke.
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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 [125]
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- Authors
- Mansi, G., Raimondi, F., Pichini, S., Capasso, L., Sarno, M., Zuccaro, P., Pacifici, R., Garcia-Algar, Ó., Romano, A., & Paludetto, R.
- Affiliations
- Federico II University Hospital (IT)
- Istituto Superiore di Sanità (IT)
- Corresponding author
- Pichini, Simona
- Venue
- Pediatric Research
- Published
- 2007-02
- Volume
- 61
- Issue
- 2
- Pages
- 257-261
- ISSN
- 0031-3998 (ISSN-L)
- 1530-0447
- OpenAlex
- W2003135575
- Cited by
- 56
- References
- 24
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 2 · 2016: 5 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 3
- FWCI
- 4.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pediatric Research (publishedVersion)
- PubMed (publishedVersion)
- 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, urinary cotinine, neonatal irritability, neonatal behavior, maternal smoking, paternal smoking, auditory responses, dose-response relationship, Brazelton Neonatal Behavioral Assessment Scale
- MeSH terms
- Cotinine, Female, Humans, Infant, Newborn, Male, Pregnancy, Smoking, Biomarkers, Infant Behavior, Maternal Exposure
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