Maternal smoking and neurodevelopmental outcomes in infants &lt;29 weeks gestation: a multicenter cohort study

Ediger, Krystyna; Hasan, Shabih U.; Synnes, Anne; Shah, Jyotsna; Creighton, Dianne; Isayama, Tetsuya; Shah, Prakesh S.; Lodha, Abhay

doi:10.1038/s41372-019-0356-3

Cited by 3 publications

(1 citation statement)

References 38 publications

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“…Ediger et al recently investigated the impact of maternal smoking and neurodevelopmental outcomes at 18 to 21 months of age in 280 exposed infants less than 29 weeks; they found maternal smoking was associated with a higher rates of the death and neurodevelopmental impairment composite, neurodevelopmental impairment alone, and lower BSID motor scores. 19 Strengths of our study stem from the original large, multicentered, and randomized-controlled trial, which enhances the generalizability of our findings. Certified research nurses collected the data prospectively, minimizing misclassification bias.…”

Section: Strengths and Limitationsmentioning

confidence: 94%

Prenatal Tobacco Exposure and Childhood Neurodevelopment among Infants Born Prematurely

et al. 2020

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Objective Nicotine is an established neuroteratogen, and prenatal tobacco exposure alters the structure of the developing nervous system. An association between prenatal tobacco exposure and impaired neurologic function is less well established. We examine the association between prenatal tobacco exposure and childhood neurodevelopment among infants born preterm. Study Design Secondary analysis of a multicenter randomized controlled trial assessing the benefits of magnesium sulfate for the prevention of cerebral palsy in preterm infants. Women were included if they delivered a singleton and nonanomalous infant before 37 weeks. Exposure was any self-reported prenatal tobacco use. Primary outcome was the original trial composite outcome of moderate or severe cerebral palsy at 2 years of age, or stillbirth, or infant death by 1 year of age. Secondary outcomes included components of the composite and mild cerebral palsy at 2 years, Bayley Scales of Infant Development II motor and mental scores, death before two years, and use of auditory aids or corrective lenses. Multivariable logistic regression models were performed to estimate adjusted odds ratios (aOR) with 95% confidence intervals. Results Of 1,826 women included, 503 (27.5%) used tobacco. Tobacco users were more likely to be older, unmarried, and white; have a prior preterm birth; have received no prenatal care; and to use illicit drugs or alcohol. Gestational age at delivery, betamethasone exposure, and magnesium exposure were not different between groups. There were no differences in the composite primary outcome or in rates of cerebral palsy by tobacco use. Moderate developmental delay was more common among tobacco exposed in bivariate but not adjusted analysis (20.5 vs. 15.9%, p = 0.035). In adjusted analysis, tobacco exposure was associated with increased use of corrective lenses (5.0 vs. 2.9%, aOR: 2.28, 95% confidence interval: 1.28–4.07). Conclusion Prenatal tobacco exposure is not associated with neurodevelopmental impairment in infants born preterm. However, tobacco exposure may be associated with impaired vision. Key Points

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Section: Strengths and Limitationsmentioning

confidence: 94%

Prenatal Tobacco Exposure and Childhood Neurodevelopment among Infants Born Prematurely

et al. 2020

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DNA methylome perturbations: an epigenetic basis for the emergingly heritable neurodevelopmental abnormalities associated with maternal smoking and maternal nicotine exposure

Buck

Knopik

et al. 2021

Biology of Reproduction

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Maternal smoking during pregnancy is associated with an ensemble of neurodevelopmental consequences in children and therefore constitutes a pressing public health concern. Adding to this burden, contemporary epidemiological and especially animal model research suggests that grandmaternal smoking is similarly associated with neurodevelopmental abnormalities in grandchildren, indicative of intergenerational transmission of the neurodevelopmental impacts of maternal smoking. Probing the mechanistic bases of neurodevelopmental anomalies in the children of maternal smokers and the intergenerational transmission thereof, emerging research intimates that epigenetic changes, namely DNA methylome perturbations, are key factors. Altogether, these findings warrant future research to fully elucidate the etiology of neurodevelopmental impairments in the children and grandchildren of maternal smokers and underscore the clear potential thereof to benefit public health by informing the development and implementation of preventative measures, prophylactics, and treatments. To this end, the present review aims to encapsulate the burgeoning evidence linking maternal smoking to intergenerational epigenetic inheritance of neurodevelopmental abnormalities, to identify the strengths and weaknesses thereof, and to highlight areas of emphasis for future human and animal model research therein.

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Harnessing the power of child development records to detect early neurodevelopmental disorders using Bayesian analysis

Hatakenaka,

Hachiya,

Åsberg Johnels

et al. 2024

Acta Paediatrica

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AimThis study aims to analyse the developmental data from public health nurses (PHNs) to identify early indicators of neurodevelopmental disorders (NDDs) in young children using Bayesian network (BN) analysis to determine factor combinations that improve diagnosis accuracy.MethodsThe study cohort was 501 children who underwent health checkups at 18 and 36‐month. Data included demographics, pregnancy, delivery, neonatal factors, maternal interviews, and physical and neurological findings. Diagnoses were made by paediatricians and child psychiatrists using standardised tools. Predictive accuracy was assessed by the receiver operating characteristic (ROC) curve analysis.ResultsWe identified several infant/toddler factors significantly associated with NDD diagnoses. Predictive factors included meconium‐stained amniotic fluid, 1 min Apgar score, and early developmental milestones. ROC curve analysis showed varying predictive accuracies based on evaluation timing. The 10‐month checkup was valid for screening but less reliable for excluding low‐risk cases. The 18‐month evaluation accurately identified children at NDD risk.ConclusionThe study demonstrates the potential of using developmental records for early NDD detection, emphasising early monitoring and intervention for at‐risk children. These findings could guide future infant mental health initiatives in the community.

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Maternal smoking and neurodevelopmental outcomes in infants <29 weeks gestation: a multicenter cohort study

Cited by 3 publications

References 38 publications

Prenatal Tobacco Exposure and Childhood Neurodevelopment among Infants Born Prematurely

Prenatal Tobacco Exposure and Childhood Neurodevelopment among Infants Born Prematurely

DNA methylome perturbations: an epigenetic basis for the emergingly heritable neurodevelopmental abnormalities associated with maternal smoking and maternal nicotine exposure

Harnessing the power of child development records to detect early neurodevelopmental disorders using Bayesian analysis

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