Published ahead of print on December 18, 2003, doi:10.1164/rccm.200305-692OC
American Journal of Respiratory and Critical Care Medicine Vol 169. pp. 733-738, (2004)
© 2004 American Thoracic Society
The Effect of Maternal Smoking on Respiratory and Arousal Patterns in Preterm Infants during Sleep
Hemant Sawnani,
Tonya Jackson,
Thomas Murphy,
Robert Beckerman and
Narong Simakajornboon
Constance S. Kaufman Pediatric Pulmonary Research Laboratory, Department of Pediatrics, Tulane University School of Medicine; and Comprehensive Sleep Medicine Center, Tulane University Hospital and Clinics, New Orleans, Louisiana
Correspondence and requests for reprints should be addressed to Narong Simakajornboon, M.D., Department of Pediatrics, SL-37, Tulane University School of Medicine, New Orleans, LA 70112. E-mail: nsimaka{at}tulane.edu
Prenatal exposure to cigarette smoke is associated with an increased risk of sudden infant death syndrome. The effect of maternal smoking on apnea and arousal patterns in preterm infants is currently unknown. Multichannel polysomnographic studies were performed in preterm infants. Thirty infants were enrolled into the study: 16 exposed prenatally to cigarette smoke (S) and 14 control infants (C). There was no difference in the gestational and postconceptional ages at the time of study. Maternal smoking was associated with a significant increase in the apneic index in these infants (28.6 ± 6.4/hour [S] vs. 13.2 ± 3.9 [C]; p < 0.05), and the difference was noted for obstructive events and only during active sleep. The arousal index was significantly decreased in the maternal smoking group (34.5 ± 2.3/hour [S] vs. 46.3 ± 5.6/hour [C]; p < 0.05), with a specific decrease in percentage of arousal after respiratory events (10.7 ± 2.1% [S] vs. 29.4 ± 5.4% [C]; p < 0.05). In conclusion, preterm infants exposed prenatally to cigarette smoke have increased respiratory events during active sleep, predominantly due to obstructive apnea, and possibly a higher arousal threshold during apneic events. These alterations in respiratory and arousal patterns in preterm infants born to smoking mothers may lead to significant vulnerability in this population.
Key Words: maternal smoking • apnea of prematurity • preterm infant • infant apnea • infant arousal
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