Maternal smoking during pregnancy and neonatal behavior

A large-scale community study

Laura R. Stroud, Rachel L. Paster, Matthew S. Goodwin, Edmond Shenassa, Stephen Buka, Raymond Niaura, Judy F. Rosenblith, Lewis P. Lipsitt

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample. METHODS. Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23% of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge. RESULTS. Sixty-two percent of the sample reported smoking during pregnancy, with 24% of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone. CONCLUSIONS. In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.

Original languageEnglish (US)
JournalPediatrics
Volume123
Issue number5
DOIs
StatePublished - May 2009

Fingerprint

Smoking
Mothers
Pregnancy
Maternal Exposure
Newborn Infant
Muscle Hypertonia
Muscles
Pregnancy Complications
Low Birth Weight Infant
Birth Weight
Social Class

Keywords

  • Behavior
  • Infant
  • Irritability
  • Muscle tone
  • Neonate
  • Pregnancy
  • Smoking

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Stroud, L. R., Paster, R. L., Goodwin, M. S., Shenassa, E., Buka, S., Niaura, R., ... Lipsitt, L. P. (2009). Maternal smoking during pregnancy and neonatal behavior: A large-scale community study. Pediatrics, 123(5). https://doi.org/10.1542/peds.2008-2084

Maternal smoking during pregnancy and neonatal behavior : A large-scale community study. / Stroud, Laura R.; Paster, Rachel L.; Goodwin, Matthew S.; Shenassa, Edmond; Buka, Stephen; Niaura, Raymond; Rosenblith, Judy F.; Lipsitt, Lewis P.

In: Pediatrics, Vol. 123, No. 5, 05.2009.

Research output: Contribution to journalArticle

Stroud, LR, Paster, RL, Goodwin, MS, Shenassa, E, Buka, S, Niaura, R, Rosenblith, JF & Lipsitt, LP 2009, 'Maternal smoking during pregnancy and neonatal behavior: A large-scale community study', Pediatrics, vol. 123, no. 5. https://doi.org/10.1542/peds.2008-2084
Stroud, Laura R. ; Paster, Rachel L. ; Goodwin, Matthew S. ; Shenassa, Edmond ; Buka, Stephen ; Niaura, Raymond ; Rosenblith, Judy F. ; Lipsitt, Lewis P. / Maternal smoking during pregnancy and neonatal behavior : A large-scale community study. In: Pediatrics. 2009 ; Vol. 123, No. 5.
@article{58e6fe11e86d4ef693a5eb174cbbd90b,
title = "Maternal smoking during pregnancy and neonatal behavior: A large-scale community study",
abstract = "OBJECTIVE. To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample. METHODS. Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23{\%} of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge. RESULTS. Sixty-two percent of the sample reported smoking during pregnancy, with 24{\%} of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone. CONCLUSIONS. In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.",
keywords = "Behavior, Infant, Irritability, Muscle tone, Neonate, Pregnancy, Smoking",
author = "Stroud, {Laura R.} and Paster, {Rachel L.} and Goodwin, {Matthew S.} and Edmond Shenassa and Stephen Buka and Raymond Niaura and Rosenblith, {Judy F.} and Lipsitt, {Lewis P.}",
year = "2009",
month = "5",
doi = "10.1542/peds.2008-2084",
language = "English (US)",
volume = "123",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "5",

}

TY - JOUR

T1 - Maternal smoking during pregnancy and neonatal behavior

T2 - A large-scale community study

AU - Stroud, Laura R.

AU - Paster, Rachel L.

AU - Goodwin, Matthew S.

AU - Shenassa, Edmond

AU - Buka, Stephen

AU - Niaura, Raymond

AU - Rosenblith, Judy F.

AU - Lipsitt, Lewis P.

PY - 2009/5

Y1 - 2009/5

N2 - OBJECTIVE. To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample. METHODS. Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23% of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge. RESULTS. Sixty-two percent of the sample reported smoking during pregnancy, with 24% of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone. CONCLUSIONS. In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.

AB - OBJECTIVE. To investigate the influence of prospectively measured smoking during pregnancy on aspects of neonatal behavior in a large community sample. METHODS. Participants were mothers and infants from the Providence, Rhode Island, cohort of the National Collaborative Perinatal Project enrolled between 1960 and 1966. Mothers with pregnancy/medical complications and infants with medical complications and/or born premature or of low birth weight were excluded. The final sample included 962 mother-infant pairs, 23% of whom were black. Maternal smoking was measured prospectively at each prenatal visit. Neonatal behavior was assessed by using the Graham-Rosenblith Behavioral Examination of the Neonate. Items from the examination were reduced to 3 subscales: irritability, muscle tone, and response to respiratory challenge. RESULTS. Sixty-two percent of the sample reported smoking during pregnancy, with 24% of smokers reporting smoking 1 pack per day or more. We found a significant influence of maternal smoking exposure (none, moderate/less than 1 pack per day, heavy/1 pack per day or more) on irritability and muscle tone in the neonate, with exposed infants showing greater irritability and hypertonicity. Effects remained significant after controlling for significant covariates: maternal socioeconomic status, age, and race and infant birth weight and age. Posthoc tests suggested particular effects of heavy smoking on increased infant irritability and both moderate and heavy smoking exposure on increased muscle tone. CONCLUSIONS. In a large community sample, exposure to maternal smoking was associated with increased irritability and hypertonicity in neonates. Exposure to maternal smoking did not influence neonatal response to respiratory challenge. This study is the largest-scale investigation to date of the effects of maternal smoking (heavy and moderate) on examiner-assessed neonatal behavior. Given the associations between both maternal smoking and infant irritability and later behavioral dysregulation, results have important implications for early identification and intervention with at-risk offspring.

KW - Behavior

KW - Infant

KW - Irritability

KW - Muscle tone

KW - Neonate

KW - Pregnancy

KW - Smoking

UR - http://www.scopus.com/inward/record.url?scp=66049091226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=66049091226&partnerID=8YFLogxK

U2 - 10.1542/peds.2008-2084

DO - 10.1542/peds.2008-2084

M3 - Article

VL - 123

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 5

ER -