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Cited by 307Prenatal Substance Exposure EffectsSmoking Behavior and CessationInfant Development and Preterm Care

Smoking during pregnancy and newborn neurobehavior

Law, Karen L., Stroud, Laura R., LaGasse, Linda L., Niaura, Raymond, Liu, Jing, Lester, Barry M.·2003·PEDIATRICS
DOI 10.1542/peds.111.6.1318
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Abstract

OBJECTIVE: This was a prospective study of the effects of maternal smoking during pregnancy on newborn neurobehavior, including dose-response relationships using self-report and a bioassay of nicotine exposure. METHODS: The sample included 27 nicotine exposed and 29 unexposed full-term newborn infants with no medical problems from comparable social class backgrounds. Mothers were excluded for using illegal drugs during pregnancy, using antidepressant medication, or if they consumed >3 alcoholic drinks per month. Nicotine exposure was determined by maternal self-report and cotinine in maternal saliva. The NICU Network Neurobehavioral Scale (NNNS) was administered by masked examiners in hospital to measure neurobehavioral function. NNNS scores were compared between nicotine-exposed and -unexposed groups including adjustment for covariates. Dose-response relationships with NNNS scores were computed for maternal salivary cotinine and maternal report of number of cigarettes per day during pregnancy. RESULTS: After adjustment for covariates, the tobacco-exposed infants were more excitable and hypertonic, required more handling and showed more stress/abstinence signs, specifically in the central nervous system (CNS), gastrointestinal, and visual areas. Dose-response relationships showed higher maternal salivary cotinine values related to more stress/abstinence signs (r =.530) including CNS (r =.532) and visual stress (r =.688) and higher excitability scores (r =.617). Cigarettes per day during pregnancy was related to more stress/abstinence signs (r =.582) including CNS (r =.561) and visual stress (r =.640). CONCLUSIONS: These findings suggest neurotoxic effects of prenatal tobacco exposure on newborn neurobehavior. Dose-response relationships could indicate neonatal withdrawal from nicotine. Research directed at understanding the effects of cigarette smoking during pregnancy on infants can lead to improved public health outcome.

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Crossref · 10.1542/peds.111.6.1318

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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 [123]

  • After adjustment for significant covariates, tobacco-exposed infants in the prior study were more excitable than unexposed infants.

    “After adjustment for significant covariates, tobacco-exposed infants were more excitable, hypertonic, and required more handling compared with unexposed infants.”

    From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [11]

  • After adjustment for significant covariates, tobacco-exposed infants in the prior study required more handling than unexposed infants.

    “After adjustment for significant covariates, tobacco-exposed infants were more excitable, hypertonic, and required more handling compared with unexposed infants.”

    From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [11]

  • After adjustment for significant covariates, tobacco-exposed infants in the prior study were more hypertonic than unexposed infants.

    “After adjustment for significant covariates, tobacco-exposed infants were more excitable, hypertonic, and required more handling compared with unexposed infants.”

    From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [11]

  • No significant group differences emerged for stress/abstinence or hypertonicity scales at 10-27 days, unlike results from the immediate newborn period.

    “Unlike results from the immediate newborn period,11 no significant group differences emerged for stress/abstinence or hypertonicity scales.”

    From Maternal Smoking during Pregnancy and Newborn Neurobehavior: Effects at 10 to 27 Days (2009) · cites this paper as [11]

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Authors
Law, K. L., Stroud, L. R., LaGasse, L. L., Niaura, R., Liu, J., & Lester, B. M.
Affiliations
Brown University (US)
ORCID
Venue
PEDIATRICS
Publisher
American Academy of Pediatrics (AAP)
Published
2003-06-01
Volume
111
Issue
6
Pages
1318-1323
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.111.6.1318
OpenAlex
W2134846589
Cited by
307
References
43
Citations by year
2026: 8 · 2025: 7 · 2024: 6 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 8 · 2016: 10 · 2015: 10 · 2014: 16 · 2013: 20 · 2012: 20
FWCI
14.06
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Cancer Institute (P50 CA84719, P50CA084719)
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, NICU Network Neurobehavioral Scale, salivary cotinine, dose-response relationship, neonatal abstinence syndrome, excitability
MeSH terms
Adolescent, Adult, Central Nervous System, Child Development, Cotinine, Dose-Response Relationship, Drug, Female, Embryonic and Fetal Development, Humans, Infant, Newborn, Maternal-Fetal Exchange, Mothers, Neonatal Abstinence Syndrome, Nicotine, Pregnancy, Prenatal Exposure Delayed Effects, Prospective Studies, Saliva, Self Disclosure, Smoking, Infant Behavior, Maternal Exposure

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