Clinics in Mother and Child Health

Abstract

Maternal Smoking during Pregnancy and Its Impact on Postnatal Neurodevelopment

Cristina Manzano, Maria Hernández Castellano, Lucia Roman, Marta Astals, Adriana Bastons Compta and Oscar Garcia Algar

Background: Nicotine from maternal active smoking or environmental tobacco smoke (ETS) is still the most prevalent substance of abuse during pregnancy in industrialized countries. The negative effects of exposure to tobacco smoke on foetus development have been widely described: impaired foetal growth and increased risks for gestational and perinatal outcomes.

Objective: The aim of this review was to provide an overview on prenatal nicotine exposure and its behavioral and neurodevelopmental deleterious effects in new-borns and children.

Method: We searched MEDLINE and EMBASE for articles catalogued between 1992 and 2015. We identified relevant published studies that assessed the association between maternal smoking and neurodevelopment deleterious effects in offspring. From 33 citations, a total of 17 studies were included.

Results: Literature definitively supports a strong association between exposed new-borns and signs of stress and neonatal withdrawal symptoms. Furthermore, an association between exposure to nicotine and attention-deficit/ hyperactivity disorder (ADHD) in children has been reported in many studies, as well as a wide range of externalizing outcomes, especially rule-breaking and aggressive behaviour, with increased risk of conduct disorders and crime.

Conclusions: It is necessary to follow up children with prenatal exposure to ETS in order to detect neurodevelopment effects during childhood. We also recommend the implementation of campaigns to avoid smoking in pregnant women, with structured medical advice and protection of pregnant women and children from ETS.