The effect of parental smoking on lung function and development during infancy

Abstract

The effect of parental smoking on lung function and development during infancy STOCKS J, DEZATEUX C. Respirology 2003; 8 : 266-285 Abstract: While the adverse effects of parental smoking on respiratory health during childhood are well recognized, its potential impact on early lung development is less clear. This review summarizes current evidence on the effect of parental smoking on lung function during infancy. It is difficult to separate the effects of pre-and postnatal exposure, since the majority of mothers who smoke in pregnancy (currently around 30% worldwide) continue to do so thereafter. Nevertheless, measurements undertaken prior to any postnatal exposure have consistently demonstrated significant changes in tidal flow patterns in infants whose mothers smoked in pregnancy. While there is, as yet, no convincing evidence from studies in human infants that smoking during pregnancy is associated with increased airway responsiveness at birth, many studies have demonstrated a reduction in forced expiratory flows (on average by 20%) in infants exposed to parental smoking. While maternal smoking during pregnancy remains the most significant source of such exposure and is likely to be responsible for diminished airway function in early life, continuing postnatal tobacco smoke exposure will increase the risk of respiratory infections, the combination of both being responsible for the two-to fourfold increased risk of wheezing illnesses observed during the first year of life in infants whose parents smoke. These findings emphasize the need to keep infants in a smoke-free environment both before and after birth, not least because of growing awareness that airway function in later life is largely determined by that during foetal development and early infancy.

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“…Differences observed between these studies may be due to the use of different devices and statistical techniques, whether or not sedation was used and the age range covered. In contrast to some previous reports, 31,32,41,42 the lack of association between lung function and exposure to maternal or household smoking in this study may reflect both the wider age range studied (impact generally being less in older infants) and the outcomes studied, the most marked reductions reported previously being in relation to forced expiratory flows. 32 Despite its proven value in epidemiological studies, the wide range of normality for t PTEF /t E precludes its use in identifying lung disease in individual infants.…”

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

“…The detrimental effects of ETS exposure on lung function have been well documented [11,85]. ETS exposure in children is associated with lower FEV1 values compared to matched unexposed children [86].…”

“…Antenatal maternal smoking has been associated with a reduction in early-life lung function suggesting that in utero smoke exposure may affect airway development and lung elasticity [87]. Maternal smoking during pregnancy and in early life is the most significant source of exposure affecting infant lung function [85]. …”

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“…Hence poor lung development in this context is a given. While prenatally-smoke-exposed infants may have tidal and forced expiratory flow rates reduced, suggesting that small airway development could have been affected (Lodrup Carlsen et al 1997;Stocks et al 2003), anatomical evidence in SIDS cases is wanting.…”