Assessment of Tobacco Exposure During Pregnancy by Meconium Analysis and Maternal Interview

2020 ◽  
Vol 44 (8) ◽  
pp. 797-802
Author(s):  
Ángela López-Rabuñal ◽  
Elena Lendoiro ◽  
Eva González-Colmenero ◽  
Ana Concheiro-Guisán ◽  
Marta Concheiro-Guisán ◽  
...  
Keyword(s):  
Birth Weight ◽  
In Utero ◽  
In Utero Exposure ◽  
Tobacco Exposure ◽  
Smoking During Pregnancy ◽  
Outcomes Measures ◽  
Significant Difference ◽  
The Matrix ◽  
Fetal Complications ◽  
Female Weight

Abstract Smoking during pregnancy can have serious obstetric and fetal complications. Therefore, it is essential to identify in utero exposure to tobacco, being meconium the matrix of choice for this purpose. Meconium (n = 565) was analyzed for nicotine, cotinine and hydroxycotinine by LC–MS-MS. Then, tobacco meconium results were compared with smoking habits during pregnancy and neonatal outcomes measures (birth weight, length, head circumference, gestational age and Apgar scores). Although meconium analysis increased identification of in-utero exposure to tobacco (17.7% meconium positive specimens vs 13.5% mothers admitting tobacco use during pregnancy), there was a statistically significant relationship between meconium results and interview answers (P < 0.001). Birth weight was significantly lower for newborns with meconium positive results in males (P = 0.023) and females (P = 0.001), while for length significance was only observed in females (P = 0.001); however, when excluding meconium specimens positive for other drugs, a statistically significant difference was only found for female weight (P = 0.045). Meconium analysis proved to be more reliable for tobacco prenatal exposure detection than maternal interview. In addition, positive meconium results increased the probability for low birth weight, especially in females.

Letter to the Editor

PEDIATRICS ◽  
1982 ◽  
Vol 70 (2) ◽  
pp. 328-328
Author(s):  
Louis E. Bartoshesky ◽  
Hermine Pashayan
Keyword(s):  
Birth Weight ◽  
Congenital Heart ◽  
Single Case ◽  
Case Reports ◽  
In Utero ◽  
Normal Male ◽  
In Utero Exposure ◽  
Congenital Heart Malformations ◽  
Male Karyotype ◽  
Heart Malformations

We would agree with both writers that there were certain features of the child described in our report that were not typical of the so-called fetal hydantoin syndrome, particularly the birth weight. It is certainly true that single case reports do nothing more than suggest possible associations between malformations and in utero exposure, but much information has been accumulated associating clefts and congenital heart malformations with phenytoin. The baby described had a normal male karyotype. Attempts were made to do karyotyping on tissue obtained at autopsy but were unsuccessful.

scholarly journals Educational attainment of children born to mothers with epilepsy

2018 ◽  
Vol 89 (7) ◽  
pp. 736-740 ◽  
Author(s):  
Arron S Lacey ◽  
William Owen Pickrell ◽  
Rhys H Thomas ◽  
Mike P Kerr ◽  
Cathy P White ◽  
...  
Keyword(s):  
Sodium Valproate ◽  
Matched Control ◽  
In Utero ◽  
Cognitive Testing ◽  
Control Group ◽  
In Utero Exposure ◽  
Minimum Standard ◽  
Matched Control Group ◽  
Significant Difference ◽  
Stage 1

ObjectiveSmall prospective studies have identified that children exposed to valproate in utero have poorer scores on cognitive testing. We wanted to identify whether children exposed to antiepileptic drugs (AEDs) in utero have poorer school performance.MethodsWe used anonymised, linked, routinely collected healthcare records to identify children born to mothers with epilepsy. We linked these children to their national attainment Key Stage 1 (KS1) tests in mathematics, language and science at the age of 7 and compared them with matched children born to mothers without epilepsy, and with the national KS1 results. We used the core subject indicator (CSI) as an outcome measure (the proportion of children achieving a minimum standard in all subjects) and the results in individual subjects.ResultsWe identified 440 children born to mothers with epilepsy with available KS1 results. Compared with a matched control group, fewer children with mothers being prescribed sodium valproate during pregnancy achieved the national minimum standard in CSI (−12.7% less than the control group), mathematics (−12.1%), language (−10.4%) and in science (−12.2%). Even fewer children with mothers being prescribed multiple AEDs during pregnancy achieved a national minimum standard: CSI (by −20.7% less than the control group), mathematics (−21.9%), language (−19.3%) and science (−19.4%). We did not observe any significant difference in children whose mothers were prescribed carbamazepine or were not taking an AED when compared with the control group.ConclusionsIn utero exposure to AEDs in combination, or sodium valproate alone, is associated with a significant decrease in attainment in national educational tests for 7-year-old children compared with both a matched control group and the all-Wales national average. These results give further support to the cognitive and developmental effects of in utero exposure to sodium valproate as well as multiple AEDs, which should be balanced against the need for effective seizure control for women during pregnancy.

scholarly journals Comparison of placental grading at different periods of gestation in PIH patients and their outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4747
Author(s):  
Sneha S. ◽  
Sreelatha S. ◽  
Renuka Ramaiah
Keyword(s):  
Birth Weight ◽  
P Value ◽  
Medical College ◽  
Medical Disorders ◽  
Biophysical Profile ◽  
Significant Difference ◽  
Fetal Complications ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Background: The current study follows grannum grading of placenta. It is well known that there is accelerated placental maturation in PIH patients and the ultrasonic appearance of grade 3 placenta before 37 weeks may signify placental dysfunction and is associated with development of low birth weight babies, IUGR meconium stained liquor, low APGAR score. Hence this study was conducted to emphasize on placental grading at different periods of gestation to predict and prevent increased obstetric and fetal compromise and to compare the outcomes.Methods: Obstetric scans were performed in all PIH patients attending antenatal OPD and inpatients at ESIC and PGIMSR medical college, Bangalore to know the placental grading and biophysical profile. These women were followed till their delivery for obstetric and fetal outcomes.Results: Grade 3 placenta is seen in 17 patients in group 1(50%) and 39 patients (59%) in group 2. For statistical analysis grade 1 and 2 were combined and compared with  grade 3. P-value 0.198 which was not statistically significant. There was no statistically significant difference in age and gravidity between two groups. The medical disorders were more in group 2 i.e., between 37 - 40 weeks. The complications of PIH were also more in group 2. There were more number of LSCS (n=19 versus 14) in 34-36 weeks group which was not statistically significant. Fetal outcomes like IUGR and IUD were more in group 2 which was not statistically significant. The mean birth weight in group 1 was 2 kg as compared to 2.7 kg in group 2. All associated medical disorders were more in group 2.Conclusions: In hypertensive women there is accelerated placental maturation leading to maternal and fetal complications. Hence women with accelerated placental maturity in ultrasound should be closely monitored and appropriately managed. However, we recommend larger randomized studies are necessary.

scholarly journals The Association Between Tobacco Exposure During Pregnancy and Newborns’ Birth Weight in DKI Jakarta Community Members

2020 ◽  
Author(s):  
Jason Phowira ◽  
Felicitas Tania Elvina ◽  
Igor Ian Wiguna ◽  
Fathurohman Ramadhan Hanif Bari Wahyudi ◽  
Bernie Endyarni Medise
Keyword(s):  
Birth Weight ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Premature Delivery ◽  
Global Public Health ◽  
Tobacco Exposure ◽  
Cross Sectional ◽  
Smoking During Pregnancy ◽  
Paternal Smoking

AbstractLow birth weight (LBW), a major determinant of neonate morbidity and mortality, remains a global public health concern. Intrauterine exposure to tobacco has been discerned as an important risk factor for LBW. This study aims to investigate the association between parental smoking during pregnancy and LBW. An analytical cross-sectional study was conducted from December 2019 - July 2020 on a random sample of parents with child aged 0-5 years old from 5 health centers in DKI Jakarta, Indonesia. A total of 145 subjects met the criteria and were analysed. Data analysis was carried out using IBM SPSS Statistics software. In the study, 11% of infants were born with LBW. The prevalence of smoking in fathers and mothers were 55.2% and 3.4%, respectively. Paternal smoking status was significantly associated with LBW (p < 0.05). Although not statistically significant, there was a dose-response relationship between paternal number of cigarettes/day and duration of smoking with LBW. Maternal smoking status (p = 0.448) was not closely associated with LBW, which might be due limited number of actively smoking mothers. From multivariate logistic regression, paternal smoking status, premature delivery, birth order and inadequate food intake during pregnancy were significant predictors of LBW (p < 0.05).

scholarly journals Increased Risk for Cerebral Hypoxia During Immediate Neonatal Transition After Birth in Term Neonates Delivered by Caesarean Section With Prenatal Tobacco Exposure

2021 ◽  
Vol 9 ◽  
Author(s):  
Christina Helene Wolfsberger ◽  
Marlies Bruckner ◽  
Bernhard Schwaberger ◽  
Lukas Peter Mileder ◽  
Ena Pritisanac ◽  
...  
Keyword(s):  
Birth Weight ◽  
Maternal Smoking ◽  
Cerebral Oxygenation ◽  
Cerebral Hypoxia ◽  
Tobacco Exposure ◽  
Tissue Oxygen ◽  
Term Neonates ◽  
Smoking During Pregnancy ◽  
Increased Risk ◽  
Smoking Group

Introduction: Maternal tobacco smoking during pregnancy is a global health problem leading to an increased risk for fetal and neonatal morbidities. So far, there are no data of the potential impact of maternal smoking during pregnancy on the most vulnerable period after birth – the immediate postnatal transition. The aim of the present study was therefore, to compare cerebral oxygenation during immediate postnatal transition in term neonates with and without prenatal tobacco exposure.Methods: Included in this post-hoc analysis were healthy term neonates, with measurements of cerebral oxygenation (INVOS 5100C) during the first 15 min after birth, and for whom information on maternal smoking behavior during pregnancy was available. Neonates with prenatal tobacco exposure (smoking group) were matched 1:1 according to gestational age (±1 week), birth weight (±100 grams) and hematocrit (±5 %) to neonates without (non-smoking group). Cerebral regional tissue oxygen saturation (crSO2), cerebral fractional tissue oxygen extraction (cFTOE), arterial oxygen saturation (SpO2) and heart rate (HR) within the first 15 min after birth were compared between the two groups.Results: Twelve neonates in the smoking group with a median (IQR) gestational age of 39.1 (38.8–39.3) weeks and a birth weight of 3,155 (2,970–3,472) grams were compared to 12 neonates in the non-smoking group with 39.1 (38.7–39.2) weeks and 3,134 (2,963–3,465) grams. In the smoking group, crSO2 was significantly lower and cFTOE significantly higher until min 5 after birth. HR was significantly higher in the smoking group in min 3 after birth. Beyond this period, there were no significant differences between the two groups.Conclusion: Cerebral oxygenation within the first 5 min after birth was compromised in neonates with prenatal tobacco exposure. This observation suggests a higher risk for cerebral hypoxia immediately after birth due to fetal tobacco exposure.

In utero exposure to bisphenol-A and its effect on birth weight of offspring

2011 ◽  
Vol 32 (1) ◽  
pp. 64-68 ◽  
Author(s):  
Maohua Miao ◽  
Wei Yuan ◽  
Guoping Zhu ◽  
Xuefei He ◽  
De-Kun Li
Keyword(s):  
Birth Weight ◽  
Bisphenol A ◽  
In Utero ◽  
In Utero Exposure

scholarly journals Maternal tobacco, cannabis and alcohol use during pregnancy and risk of adolescent psychotic symptoms in offspring

2009 ◽  
Vol 195 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Stanley Zammit ◽  
Kate Thomas ◽  
Andrew Thompson ◽  
Jeremy Horwood ◽  
Paulo Menezes ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Alcohol Use ◽  
Causal Effect ◽  
Structured Interview ◽  
In Utero ◽  
Psychotic Symptoms ◽  
Psychotic Experiences ◽  
Tobacco Exposure ◽  
Smoking During Pregnancy ◽  
Increased Risk

BackgroundAdverse effects of maternal substance use during pregnancy on fetal development may increase risk of psychopathology.AimsTo examine whether maternal use of tobacco, cannabis or alcohol during pregnancy increases risk of offspring psychotic symptoms.MethodA longitudinal study of 6356 adolescents, age 12, who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort.ResultsFrequency of maternal tobacco use during pregnancy was associated with increased risk of suspected or definite psychotic symptoms (adjusted odds ratio 1.20, 95% CI 1.05–1.37, P = 0.007). Maternal alcohol use showed a non-linear association with psychotic symptoms, with this effect almost exclusively in the offspring of women drinking >21 units weekly. Maternal cannabis use was not associated with psychotic symptoms. Results for paternal smoking during pregnancy and maternal smoking post-pregnancy lend some support for a causal effect of tobacco exposure in utero on development of psychotic experiences.ConclusionsThese findings indicate that risk factors for development of non-clinical psychotic experiences may operate during early development. Future studies of how in utero exposure to tobacco affects cerebral development and function may lead to increased understanding of the pathogenesis of psychotic phenomena.

scholarly journals Hypomethylation in FASTKD1 detected in the association between in utero tobacco exposure and conduct problem in a New Zealand longitudinal study

2021 ◽  
Author(s):  
Alexandra J Noble ◽  
John F Pearson ◽  
Joseph M Boden ◽  
L. John Horwood ◽  
Martin A Kennedy ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Tobacco Use ◽  
Multiple Testing ◽  
Conduct Problem ◽  
In Utero ◽  
In Utero Exposure ◽  
Tobacco Exposure ◽  
Nominal Significance ◽  
A Genome ◽  
Maternal Tobacco Use

Despite the known adverse effects of in utero tobacco exposure on offspring health, maternal tobacco use during pregnancy remains prevalent and is a major driver of health inequalities. One such health inequality is the development of conduct problem (CP) in exposed offspring which may be mediated by methylation changes that persist into adulthood. Here we apply a genome-wide approach to probe the association between maternal tobacco use during pregnancy and CP outcomes in exposed offspring. We examined maternal tobacco use during pregnancy (in utero exposure) in the Christchurch Health and Development Study, a longitudinal birth cohort studied for over 40 years. We then evaluated the interaction between methylation effects of in utero exposure and CP score. When modelling this interaction between in utero exposure and CP score we detected nominal DNA methylation differences, at FASTKD1 which has roles in early development. Our observations are consistent with DNA methylation mediating the development of CP following in utero tobacco exposure. In addition, we detected nominal significance in FRMDA4 and MYO1G between individuals exposed to tobacco in utero and those that were unexposed, however these did not reach significance after adjustment for multiple testing. However due to limited power in our analysis, further studies are needed to investigate the interaction between in utero tobacco exposure and high CP health outcomes.

scholarly journals In Utero Exposure to Particulate Air Pollution during Pregnancy: Impact on Birth Weight and Health through the Life Course

2020 ◽  
Vol 17 (23) ◽  
pp. 8948
Author(s):  
Susanne Steinle ◽  
Helinor J. Johnston ◽  
Miranda Loh ◽  
William Mueller ◽  
Sotiris Vardoulakis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Air Pollution ◽  
Birth Weight ◽  
Health Effects ◽  
In Utero ◽  
Health Impacts ◽  
In Utero Exposure ◽  
Lower Birth Weight ◽  
Particulate Air Pollution ◽  
The Life Course

In high-income countries, and increasingly in lower- and middle-income countries, chronic non-communicable diseases (NCDs) have become the primary health burden. It is possible that in utero exposure to environmental pollutants such as particulate matter (PM) may have an impact on health later in life, including the development of NCDs. Due to a lack of data on foetal growth, birth weight is often used in epidemiologic studies as a proxy to assess impacts on foetal development and adverse birth outcomes since it is commonly recorded at birth. There are no research studies with humans that directly link PM exposure in utero to birth weight (BW) and subsequently, the effects of lower BW on health outcomes in old age. It is, however, plausible that such associations exist, and it is thus important to assess the potential public health impacts of PM across the life course, and it is plausible to use birth weight as an indicator of risk. We therefore split this narrative review into two parts. In the first part, we evaluated the strength of the evidence on the impact of PM exposure during the entire pregnancy on birth weight outcomes in ten meta-analyses. In the second part, we reviewed the literature linking lower birth weight to childhood and adult chronic cardiovascular disease to explore the potential implications of PM exposure in utero on health later in life. Within the reviewed meta-studies on birth weight, there is sufficient evidence that PM pollution is associated with lower birth weight, i.e., the majority of meta-studies found statistically significant reductions in birth weight. From the second part of the review, it is evident that there is good evidence of associations between lower birth weight and subsequent cardiovascular disease risk. It is thus plausible that in utero exposure to PM is associated with lower birth weight and persisting biological changes that could be associated with adverse health effects in adulthood. Based on the reviewed evidence, however, the magnitude of later life cardiovascular health impacts from in utero exposure and its impact on BW are likely to be small compared to health effects from exposure to particulate air pollution over a whole lifetime.

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